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HX641 27265 
RC445  .Y7  Care  of  the  feeble^  ^ 

OF 


THE   UNIVERSITY  OF  TEXAS 


NUMBER  369 
SIX.  TIMES   A  MONTH 


HUMANISTIC  SERIES  NO.  .16 


NOVEMBER  5,  1914 


Care  of  tie  Feeble-minaed  and  Insane 

in  Texas 


BY 


C.  S.  YOAKUM,  PH.  D. 


J 


PUBLISHED  BY  THE  UNIVERSITY  OF  TEXAS 
AUSTIN,  TEXAS 


Entered  as  second-elass  mail  matter  at  the  postoffice  at  Austin,  Texas 


Columbia  WLnihzx&ity 
in  tfje  Citp  of  i^etu  Horfe 

College  of  ^fjpgtctana  anb  ££>urgeon$ 


Reference  Htbrarp 


524-614-lm-5966 


BULLETIN 


OF 


THE   UNIVERSITY  OF  TEXAS 


NUMBER   369 

SIX  TIMES  A  MONTH 


HUMANISTIC  SERIES  NO.  16 


NOVEMBER  5,  1914 


Care  of  the  Feeble-minded  and  Insane 

in  Texas 


BY 


C.  S.  YOAKUM,  PH.  D. 


PUBLISHED  BY  THE  UNIVERSITY  OF  TEXAS 
AUSTIN,  TEXAS 


Entered  as  second-class  mail  matter  at  the  postoffice  at  Austin,  Texas 


TABLE    OF    CONTENTS 

Page 

Introduction 11 

Desirable  and  undesirable  citizens 11 

Cost  of  the  undesirable 12 

Social  problems  involved 13 

The  feeble-minded  and  the  insane 14 

The  Feeble-minded 15 

Nature  of  feeble-mindedness 15 

Definition 15 

American  classification 16 

Barr's  classification 16 

The  Situation  in  Texas 17 

State's  responsibility 17 

No  data  available 18 

Results  of  letter  to  County  Judges 20 

Special  Room  in  Houston  Schools 21 

Training  School  at  Gatesville 21 

Estimates  of  number  of  feeble-minded  in  Texas 22 

Table  showing  probable  increase  in  Texas 22 

Causes  of  feeble-mindedness 24 

Table  showing  causes 25 

Heredity 25 

Alcoholism 29 

Tuberculosis .' 29 

Extrinsic  factors 30 

Social  significance  of  these  causes 31 

The  defective  in  society 33 

Criminal  and  anti-social  tendencies 33 

The  defective  delinquent 34 

Children  of  school  age 35 

Illustrative  types 36 

The  problem  and  its  solution 44 

History  of  educational  treatment 47 

Itard  and  the  wild  boy  of  Caunne 49 

Guggenbiihl  and  the  cretins 49 

Seguin  and  the  physiologic  method 50 

Dr.  Howe  in  America 51 

Segregation  and  State  care 54 

Michigan's  call  for  segregation 54 

Problem  of  the  reformatory 55 

"Emma  W" 56 

Necessity  for  permanent  segregation 58 

Classifications  used 58 


4  Bulletin  of  the  University  of  Texas 

Page 

Modern  institutions  and  colonies 60 

The  call  from  Texas;  Letter  to  Prof.  Potts 60 

Can  we  educate? 61 

Forms  of  training 62 

Syracuse  school  for  feeble-minded 65 

Types  needing  segregation 66 

Letter  to  Hon.  I.  B.  Reeves,  Sherman 67 

Two  other  cases : 67 

English  Royal  Commission's  report 69 

Letchworth  Colony,  New  York 70 

Farming  in  Illinois 74 

Templeton,  Mass.,  colony 75 

Legal  enactment  and  State  Policy 77 

Principles  of  the  Illinois'  Charity  Law 77 

Idiots'  Act  of  1886,  England : 78 

Findings  of  the  Royal  Commission 78 

States  having  no  institutions 79 

Legislative  enactment  in  Texas 80 

Conclusions 80 

"The  Burden  of  the  Feeble-Minded" 80 

Methods  of  prevention — Eugenics 81 

Authorized  investigating  agencies 83 

The  Insane 84 

Importance  of  general  information 84 

Nature  of  insanity 86 

Definition 86 

General  symptoms 86 

Two  specific  disease  pictures 88 

Early  signs  of  nervous  weakness , 92 

Causes  of  insanity 95 

Heredity 96 

Physical  ill-health 98 

Worry 99 

Prevalence  of  insanity 99 

The  United  States 99 

In  Texas 100 

State  policy  toward  the  insane 100 

Haphazard  policies 101 

Regarded  as  criminals 101 

Regarded  as  diseased 104 

Prevention 105 


Care  of  the  Feeble-minded  and  Insaave  in  Texas  5 

Conditions  in  Texas 107 

Population  of  our  hospitals 107 

Present  methods  unsatisfactory 108 

Conditions  in  jails  and  poor  farms 109 

Bell  County 109 

Bexar  County 110 

Collin  County 113 

Dallas  County 114 

Ellis  County 118 

Grayson  County 119 

Harris  County 119 

Hays  County 120 

Hill  County 122 

Hunt  County 122 

Johnson  County 122 

Lamar  County 123 

McLennan  County 126 

Tarrant  County 128 

Travis  County 128 

Table  showing  number  of  insane  in  jails,  etc 129 

Proper  care  and  treatment  of  the  insane 133 

Historical  statement 133 

Contrast  with  Texas'  conditions 134 

Modern  methods 135 

Receiving  hospital 135 

Colony  plan 136 

After-care  and  out-patient  work 138 

Psychopathic  laboratories 138 

Voluntary  patients 139 

Legal  aspects  of  insanity 139 

Legal  principles 139 

Insane  as  'centers  of  infection'  in  society 140 

Various  methods  of  commitment 142 

Conveyance,  parole,  and  discharge 143 

Needs  of  Texas 144 

State  Board  of  Supervision < 145 

Modern  hospitals 145 

Colonies  for  the  feeble-minded  and  insane :...  145 

Jails  emptied  of  insane  and  feeble-minded 145 

Preparation  for  the  future 146 

Bibliography 147 


ILLUSTRATIONS 

Plates  Page 

I  Tarrant  county  feeble-minded 18 

II  Grayson  county  feeble-minded 19 

III  Grayson  county  insane  and  feeble-minded 19 

IV  Houston  Special  Room  Group 21 

V  Cases  E.  and  H.,  Elwyn,  Pa %  36 

VI  Cases  A.  B.  C.  and  D.,  Elwyn,  Pa 38 

VII  Cases  E.  and  F.,  Elwyn,  Pa 39 

VIII  Cases  B.  C.  D.  and  E.,  Elwyn,  Pa 42 

IX  Dallas  County  Poor  Farm,  Idiots 43 

X  Bexar  County  Poor  Farm,  Idiot 48 

XI  Exhibit  of  work  in  Houston  school 51 

XII  Grayson  County  Poor  Farm,  Imbeciles 52 

XIII  "Emma  W" 56 

XIV  Heredity  Chart  of  "Emma  W" 57 

XV  Sloyd  Room,  feeble-minded  working 63 

XVI  Manual  training  in  Houston 64 

XVII  Amusements ! 72 

XVIII  Feeble-minded  at  work 76 

XIX  Restraint  vs.  Hydrotherapy 93 

XX  Housing  of  the  insane 103 

XXI  Bexar  county  jail,  insane  ward 106 

XXII  Bell  county  jail,  insane 110 

XXIII  Bexar  county  jail,  insane  patients Ill 

XXIV  Collin  county  poor  farm,  insane 113 

XXV  Hill  county  poor  farm,  housing 121 

XXVI  Tarrant  county  poor  farm,  insane 127 

XXVII  Pinel  at  Bicetre,  1792 134 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/careoffeeblemindOOyoak 


FOREWORD. 

This  paper  published  as  a  Bulletin  of  the  University  of  Texas 
constitutes  a  part  of  the  report  of  the  Committee  on  Mental 
Hygiene  of  the  State  Conference  of  Charities  and  Corrections. 
The  collection  and  publication  of  material  descriptive  of  neglect 
and  ignorance  in  dealing  with  mental  unsoundness  in  Texas  is 
not  a  pleasant  task,  but  the  facts  are  such  that  we  may  not  with- 
hold them.  They  are  patent  in  each  and  every  community  in 
the  State.  We  have  also  endeavored  here  to  set  forth  the  most 
humane  methods  uow  existing,  of  dealing  with  this  menace  of 
feeble-mindedness  and  mental  disease.  If  we  in  Texas  heed  the 
experience  of  older  countries,  we  shall  be  able  to  check  this  malig- 
nant growth  on  our  people :  to  neglect,  to  delay  means  a  rapidly 
growing  financial  burden  on  all;  but  more  terrible  still,  it  means 
ever  increasing  numbers  of  our  fellow  citizens  are  doomed  to 
mental  deca}r  and  death  while  yet  living. 


INTEODUCTION. 

Every  state,  to  maintain  the  highest  efficiency  in  its  govern- 
mental and  social  functions,  must  consider  the  nature  of  its  citi- 
zens. We  are  in  the  habit  of  dividing  citizens  into  two  classes 
based  on  their  value  to  society  or  their  amenableness  to  social 
custom  and  law, — desirable  and  undesirable  citizens.  The  latter 
class  comes  in  conflict  with  law  and  is  generally  considered  a 
menace  to  good  government.  Scientific  study  and  research  today 
show  us  that  this  class  is  composed  of  two  groups,  the  delinquent 
and  criminal,  or,  properly  speaking,  the  undesirable  citizen,  the 
class  that  has  ideas  and  performs  actions  that  are  inimical  to 
social  health;  and  a  second  group  composed  of  the  mental  and 
moral  defectives  and  the  defective-delinquent,  the  socially  unfit 
through  deprivation  of  desirable  qualities  and  by  inheritance  of 
undesirable  ones,  from  defective  strains,   and  diseases. 

The  criminal  code,  jails,  prisons,  and  all  forms  of  punishment 
are  of  no  avail  in  dealing  with  the  second  group.  They  are  not 
responsible  individuals  and  any  means  suitable  to  the  reformation 
of  the  adult  human  in  society  will  fail  of  its  purpose  when  applied 
to  these  mental  and  social  defectives.  The  development  of  the 
juvenile  court,  the  indeterminate  sentence,  the  parole  system,  etc., 
are  evidence  of  society's  attempt  to  reform,  and  reclaim  the  border 
line  cases  between  the  classes  above  described.  However,  without 
special  institutions,  such  as  parental  schools  and  schools  for  feeble- 
minded, where  special  training  by  experts  can  be  given,  none 
of  the  defectives  can  be  reclaimed  and  the  large  majority  of  this 
class  can  never  be  self -controlled  or  self-sustaining  even  after  the 
best  training  available.  They  must  always  depend  on  others  for 
care  and  support.  The  insane,  while  socially  unfit,  are  also  sick. 
The  immediate  social  problem  here,  when  once  understood,  is  rel- 
atively simple;  yet  from  the  standpoint  of  society  the  insane  be- 
long, during  the  continuance  of  the  disease,  in  the  second  class, 
among  the  socially  unfit  and  irresponsible. 

These  two  classes  of  unfortunates,  the  defective  and  the  insane, 
are  to  be  considered  as  demanding  the '  special  attention  of  the 
State.-  Both  are  incapable  of  maintaining  their  positions  in  soci- 
ety.    They  are  perhaps  most  frequently  found  among  the  poorer 


]2  Bulletin  of  the  University  of  Texas 

classes,  largely  because  of  their  mental  defects  or  diseases.  They 
may  be  found,  for  example,  in  our  jails  and  almshouses;  they  may 
always  be  discovered  on  the  books  of  our  charity  organizations; 
and  they  constitute  a  large  percentage  of  our  criminal  classes. 
Indirectly  the  burden  upon  society  is  enormous,  and  under  our 
present  laws  and  management  in  Texas,  wholly  incalculable. 
Directly,  we  know  that  the  three  insane  asjdums  in  the  State  have 
a  property  valuation  of  $2,000,000,  and  the  yearly  expense  of 
maintaining  them  is  over  $700,000.  (Texas  is  doing  absolutely 
nothing  for  its  feeble-minded  population, — a  class  of  unproductive 
persons  running  up  into  the  thousands  and  steadily  increasing  in 
numbers.)  It  costs  approximately  $20,000,000  per  }^ear  to  run 
Texas'  police  courts,  jails,  poor  farms,  and  penitentiaries.*  Al- 
most 50  per  cent  of  the  population  in  them  and  up  for  trial  from 
one  to  fifty  times  in  a  lifetime  are  feeble-minded  or  of  low  grade 
mentally. 

Over  all  these  sources  of  crime,  poverty,  and  financial  loss, 
Texas  exercises  no  general  control.  The  penitentiary  system  has 
been  inaugurated  within  quite  recent  years  and  is  yet  in  the 
making.  Provision  is  made  for  the  insane  of  the  State  from  time 
to  time  when  the  necessity  therefor  becomes  imperative.  No  pro- 
vision whatsoever  is  made  for  the  feeble-minded  and  hopeless 
mental  defectives. 

The  fundamental  issue  can  be  met  only  by  the  establishment 
of  permanent  agencies  for  the  study  and  solution  of  these  intricate 
social  problems.  A  broad-minded  policy,  looking  out  over  years 
to  come,  should  be  formulated,  and  all  the  institutions  enumerated 
above  and  others  as  the}'  are  established  in  the  future  should  be 
included  in  the  scope  of  such  a  policy. 

Our  studies  in  this  paper  will  be  concerned  largely  with  these 
two  special  classes,  the  mental  defective  and  mentally  diseased. 
By  feeble-minded  we  mean  that  class  of  individuals  who  show 
"defects  either  mental  or  moral  or  both."  We  use  the  term  here 
in  the  American  sense  to  include  all  grades  of  mental  deficiency 
and  defect.  The  English  usage  classifies  individuals  as  "feeble- 
minded" who  are  "persons  who  may  be  capable  of  earning  a  living 

"Compare  Potts,  C.  S.,  Care  and  Treatment  of  Criminals,  Bulletin  Uni- 
versity of  Texas  No.  146,  p.  8;  also  Eugenics  Eecord  Office  Bulletin  No. 
10B,  p.   147. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  13 

under  favorable  circumstances,  but  are  incapable  from  mental 
defect  existing  from  birth  or  from  an  early  ag( — (a)  of  com- 
peting on  equal  terms  with  their  normal  Fellows,  or  (b)  of  man- 
aging themselves  or  their  affairs  with  ordinary  prudence." 
Idiots,  imbeciles,  etc.,  are  divisions  that  include  the  lower  types 
in  the  English  classifications;  these  are  subdivisions  of  the  "feeble- 
minded" in  the  American  terminology.  All  grades  of  defect  may 
be  found,  and  such  mental  defects  are  usually  associated  with 
various  physical  stigmata  of  degeneration.  Socially,  this  class  of 
individuals  ranges  from  those  who  remain  helpless  infants  all 
their  lives,  through  numerous  stages  of  higher  mental  development, 
simulating  all  the  periods  of  childhood.  "Although  incurable,  the 
lesser  forms  [of  feeble-mindeclness]  may  be  susceptible  for  ame- 
lioration and  of  modification,  just  in  proportion  as  they  have 
been  superinduced  by  causes  congenital  or  accidental." 

The  insane  include  those  who  have  developed  to  some  level  of 
adult  mental  life  and  then  through  various  causative  agencies 
have  lost  that  development.  The  deaf  and  dumb,  the  blind,  the 
backward  children  in  school,  the  criminal,  belong,  socially  speak- 
ing, in  one  or  the  other  of  these  socially  unfit  classes.  Study  and 
careful  investigation  alone  can  determine  the  precise  mental  classi- 
fication of  the  individual  that  society  and  the  law  readily  recognize 
as  unfit  for  responsibility  and  human  association. 

"We  shall  try  to  show  the  results  of  such  studies  in  so  far  as 
they  indicate  (a)  the  causes  of  mental  deficiency  and  disease; 
(b)  the  care  and  treatment  of  such  unfortunates,  and  (c)  modern 
methods  of  prevention.  Special  reference  will  be  made  contin- 
ually to  the  present  situation  in  Texas,  and  as  far  as  possible  our 
illustrations  will  be  drawn  from  conditions  now  actually  existing 
within  the  State.  To  limit  the  length  of  such  a  discussion  special 
study  will  be  made  of  the  feeble-minded  and  insane  only,  the 
problem  of  the  mentally  unfit.  What  can  society  do  to  prevent 
their  increase?  What  must  it  do  for  those  already  in  its  midst? 
What  methods  will  enable  the  State  to  reduce  the  cost  of  their 
maintenance,  at  the  same  time  giving  these  unfortunates  the  high- 
est degree  of  training,  protection,  care,  and  enjoyment,  of  which 
they  are  capable? 

Broadly  speaking,  we  must  separate  the  mentally  unfit  into  two 


14  Bulletin  of  the  University  of  Texas 

classes,  the  defective  and  the  insane.  The  first  class  is  called  the 
feeble-minded,  the  idiots  and  imbeciles,  the  aments,  and  is  in- 
curable in  all  but  exceptional  cases.  The  insane  are  mentally 
diseased,  and  the  treatment  accorded  any  sick*  person  is  their  due. 
Merely  because  they  exhibit  peculiar  social  characteristics,  or  their 
disease  seems  to  us  of  a  more  serious  nature  than  the  ordinary 
disease,  in  no  way  lessens  the  need  for  skilled  advice  and  treat- 
ment. Under  such  care  over  40  per  cent  of  these  mentally  dis- 
eased persons  have  recovered  and  returned  to  their  homes  and 
their  work. 

*The  writer  has  used  the  word  "sick"  to  describe  any  condition  of  mind 
needing  expert  treatment.  Its  meaning  thus  approximates  that  of  "ab- 
normal." 


CARE   OF  THE    FEEBLE-MINDED    AND    IN- 
SANE IN  TEXAS 


THE    FEEBLE-MINDED. 

Numerous  definitions  of  the  term  are  in  use.  We  have  already 
quoted  one  from  Barr.  At  present  all  classes  of  mental  defect 
depending  on  causes  that  have  prevented  the  development  of  mind 
into  a  normal  adult  are  classed  under  this  heading.  It  is  true 
that  among  abnormal  or  anormal  children  and  adults  other  types 
may  he  found;  more  general  divisions  may  be  made.  Miss  Ban- 
croft* gives  an  interesting  division  with  this  purpose  in  view: 
"First  those  that  are  backward,  by  reason  of  some  sensory  defect 
or  motor  deficiency;  second,  the  mentally  weak;  third,  the  men- 
tally deficient;  fourth,  the  morally  weak,  and,  as  an  exaggerated 
form  of  the  same,  the  morally  deficient."  In  feeble-mindedness 
proper,  however,  the  mental  growth  is  stunted  through  mental 
weakness  and  deficiency.  The  idiot,  the  imbecile,  and  the  higher 
types  of  mental  defect  are  all  included  within  the  limits  of  the 
term.  Professor  Hueyt  'gives  the  classification  adopted  by  the 
American  Association  for  the  Study  of  the  Feeble-minded. 

This  association  in  1910  adopted  the  practice  about  as  it  has 
been  established  in  this  country  in  the  larger  institutions. 

1.  "The  term  'feeble-minded'  is  to  be  used  generically  to  in- 
clude all  degrees  of  mental  defect  due  to  arrested  or  imperfect 
mental  development,  as  a  result  of  which  the  person  so  affected 
is  incapable  of  competing  on  equal  terms  with  his  moral  fellows, 
or   of  managing   himself   or   his   affairs   with   ordinary  prudence. 

2.  The  feeble-minded  are  divided  into  three " classes,  viz: 
Idiots. — Those  so  defective  that  their  mental  development  never 

exceeds  that  of  a  normal  child  of  about  two  years. 

Imbeciles. — Those  whose  development  is  higher  than  that  of 
an  idiot,  but  whose  intelligence  does  not  exceed  that  of  a  normal 
child  of  about  seven  years. 

*National  Conf.  of  Char,  and  Cor.,   1901,  p.  193. 

fHuey,  E.  B.,  Backward  and  Feeble-minded  Children.  Baltimore,  1912, 
p.   6. 


16 


Bulletin  of  the  University  of  Texas 


Morous. — Those  whose  mental  development  is  above  that  of 
an  imbecile,  but  does  not  exceed  that  of  a  normal  child  of  about 
twelve  years." 

Each  of  the  three  grand  divisions  is  subdivided  into  low,  middle, 
and  high.  The  use  of  the  terms  is  illustrated  in  such  combina- 
tions as  "low  Mongolian  imbeciles,"  "high  epileptic  moron." 

The  terms  "backward,  retarded,  unstable,"  are  used  where  the 
individual  shows  an  intelligence  that  falls  within  three  years  of 
normal  or  where  instability  of  character  is  the  chief  sign  of 
defective  growth. 

We  may  accept  this  classification  as  a  usable  division,  provid- 
ing we  remember  that  it  contains  nothing  final  and  is  simply  an 
attempt  to  find  a  working  basis  for  the  study  and  treatment  of 
these  classes.  Other  classifications  are  in  use  and  offer  advan- 
tages of  various  kinds.  Barr  gives  one  based  on  the  educational 
possibilities  of  the  individuals. 


EDUCATIONAL  CLASSIFICATION  OF  FEEBLE-MINDED. 

IDIOT 


Asylum  Care 


Profound     /  Apathetic      \  Unimprovable. 
\  Excitable       J 

Superficial  /  Apathetic      \  Improvable  in  self-help  only. 
\  Excitable       j 

IDIO-IMBECILE 

Improvable    in    self-help    and    helpfulness.     Trainable    in    a    very 
limited  degree  to  assist  others. 

MORAL  IMBECILE 

Mentally  and  morally  deficient. 

Low  Grade:     Trainable     in     industrial     occupations;     temperament 

bestial. 
Middle  Grade:     Trainable    in    industrial    and    manual    occupations; 

a  plotter  of  mischief. 
High  Grade:     Trainable    in    manual    and    intellectual    arts,    with    a 

genius  for  evil. 

f  •  IMBECILE. 

Long    Appren-  I  Mentally  deficient, 
ticeship  and      |  Low  Grade:     Trainable   in   industrial   and   simplest   manual   occupa- 
Colony  Life     \  tions. 

Under  Protec-  |  Middle  Grade:     Trainable    in    manual    arts     and    simplest     mental 
tion.  acquirements. 

[High  Grade:     Trainable  in  manual  and  intellectual  arts. 


Custodial  Life 
and  Perpetual 
Guardianship 


Trained  for 
a  Place  in 
the  world. 


f  BACKWARD  OR  MENTALLY  FEEBLE. 

1  Mental  processes  normal,  but  slow  and  requiring  special  training  and 
I  environment    to    prevent    deterioration;    defect    imminent    under 

slightest  provocation,  such  as  excitement,  over-stimulation,   and 
I  illness. 


His  classification  and  arrangement  gives  at  a  glance  the  prob- 


Care  of  the  Feeble-minded  mid  Insane  in  Texas  17 

able  lifelong  status  of  the  persons  composing  its  divisions  and 
indicates  in  a  general  way  what  we  may  hope  to  do  in  the  way 
of  training  and  care  in  each  class.  It  is  based  on  his  own  study 
and  work  in  the  Pennsylvania  Training  School  for  Feeble-minded 
Children  at  Elwyn,  Pennsylvania.  Other  classifications  may  he 
arranged.  Insanity  and  mental  derangement  in  general  may  be 
viewed  as  congenital  and  acquired,  the  congenital  type  including 
our  classes  of  the  feeble-minded.  We  may  classify  on  the  basis 
of  origin  and  causes  and  thus  obtain  such  primary  groups  as 
(a)  Congenital;  (b)  Developmental:  (c)  Accidental,  with  their 
subdivisions. 

For  the  protection,  segregation,  and  training  of  these  unfor- 
tunates, duties  that  devolve  upon  society  and  the  State,  Barr's 
classification  is  perhaps  the  most  satisfactory.  The  skilled  expert 
in  the  employ  of  the  State,  after  careful  examination,  can  indi- 
cate at  once  the  needs  of  each  applicant.  The  institution  estab- 
lished by  the  State  can  easily  be  planned  on  the  basis  of  the  ade- 
quate training  and  care  of  all  classes.  The  problem  of  preventing 
the  increase  of  these  undesirable  classes  will  demand  other  and 
more  scientific  classifications;  but  these  will  merely  define  more 
sharply  the  group  given  above. 

THE  SITUATION  IX  TEXAS. 

"A  word  to  the  West! 

"The  State  faces  grave  responsibilities  in  respect  to  the  weaker 
classes.  Statistics  of  their  extent  among  the  population  are  well 
known.  New  States  and  communities  should  equip  themselves 
properly  to  attack  these  problems,  and  should  make  their  plans 
on  the  basis  of  complete  control.  Had  the  States  of  the  East 
followed  this  method  during  the  last  fifty  years  their  burdens 
would  be  only  a  fraction  as  great  as  they  now  are.  By  wise 
organization  many  of  the  economic  and  social  problems  which 
accompany  large  populations  may  be  avoided.  The  planning  of 
cities,  housing  and  sanitary  laws,  regulations  respecting  educa- 
tion and  labor,  the  establishment  of  playgrounds  and  systems  of 
medical  inspection,  as  well  as  the  supervision  and  administration 
of  institutions  of  charity  and  correction,  constitute  scientific  tasks, 


18 


Bulletin  of  the  University  of  Texas 


and  there  should  he  properly  organized  public  bureaus  to  attend 
to  them."* 

Not  long  ago  I  received  a  letter  of  inquiry  asking  if  any  figures 
could  be  given  on  the  estimated  per  cent  of  feeble-minded  persons 
in  the  State  of  Texas.  The  writer  of  the  inquiry  was  in  charge 
of  an  institution  for  wayward  girls,  f  and  she  stated  that  she  found 
in  this  institution  a  very  large  percentage  of  border-line  feeble- 
minded girls,  and  stated  also  that  she  heard  there  was  an  appall- 
ingly large  number  of  such  feeble-minded  persons  in  the   State. 


Plate  I. 

High  and  low-grade  imbeciles  at  the  Tarrant  county  poor  farm.  The  mother 
of  the  one  on  the  left  killed  her  husband  and  was  sent  to  prison.  Other  mem- 
bers of  all  three  families  represented  here  are  known  to  be  feeble-minded.  The 
mother  of  a  fourth  idiot  on  this  farm  died  in  an  almshouse  in  Missouri.  The 
two  standing  are  trainable. 

In  answering  this  letter  I  found  it  impossible  to  give,  from  any 
statistics  or  census  reports  anything  definite  concerning  the  num- 
ber of  individuals  of  this  class  in  the  State. 

During  the  early  part  of  1914  the  writer,  therefore,  sent  out 
an  information  blank  to  all  the  county  judges  of  Texas  requesting 
data    on    the    feeble-minded    and    insane    at    large   in    the    State. 


*Report    of    Committee    on    Public    Supervision    and   Administration    to 
National   Conference   of   Charities   and    Corrections,   Seattle,    1913,   p.   194. 
fSee  p.   114  and  footnotes  there. 


Plate  J  I. 


Plate  III. 


Two  feeble-minded  boys  on  the  Grayson  county  farm.  By  looking 
closely,  one  can  see  below  the  horizontal  bar  the  strap  that  ties  this 
older  boy's  hands  behind  his  back.  He  is  kept  this  way  all  day,  and  has 
been  tied  each  day  for  almost  four  years.  He  is  fairly  intelligent  but 
wholly  untaught.  In  the  cells  back  in  this  jail  are  three  insane  and  one 
epileptic;    all   in  an   unkempt  and   untidy  condition. 


20  Bulletin  of  the  University  of  Texas 

Practically  all  of  the  counties  replied  with  definite  information 
on  the  insane  population  as  shown  in  the  table  below,  p.  129 ;  but 
the  data  on  the  feeble-minded  is  inaccurate  and  meager.  The 
reports  where  replies  were  received  give  fifty-eight  idiots  and 
feeble-minded  in  the  county  jails ;  and  a  total  of  one  hundred  and 
forty-eight  on  county  poor  farms  so  feeble-minded  that  their  con- 
dition is  readily  detected  by  the  most  inexperienced  observer. 

The  county  judge  at  Lubbock,  Texas,  writes:  "We  have  one 
man  about  twenty-six  years  old  here  that  is  simple-minded,  but 
we  have  placed  no  restraint  around  him.  He  should  be  in  some 
State  institution."  I  am  privileged  to  quote  from  a  letter  re- 
ceived  by    another    of    the    county    judges.     It    runs    as    follows: 

"Mr. told  me  that  I  could  get  our  little  girl  in  an 

institution  at  Terrell,  Texas,  but  I  would  have  to  work  through 
the  county  judge.  So  I  will  ask  you  to  help  me.  You  write  to 
Dr.  Powell  at  Terrell  and  see  what  can  be  done  .  .  .  you  No 
my  circumstance  without  me  telling  you,  .  .  .  etc."  A  third 
county  judge  writes:  "We  have  one  boy  about  sixteen  years  old 
in  jail;  he  is  so  bad  his  parents  can't  keep  him.  There  is  also  a 
very  crazy  negro  in  jail."  From  still  another  county  we  learn 
that  "the  county  cares  for  the  feeble-minded  at  the  county  farm. 
Some  on  the  farm  have  been  feeble-minded  since  infancy,  and 
they  are  all  advanced  in  age."  These  quotations  give  us  the 
barest  hint  of  conditions  in  our  State.  No  one  knows  how  many 
feeble-minded  children  and  adults  there  are  running  at  large 
in  the  cities  and  villages  of  Texas.  We  know,  from  stories  gath- 
ered here  and  there,  of  isolated  cases,  and  we  know  from  the 
Social  Service  Workers  of  the  State  that  conditions  differ  very 
slightly  from  the  conditions  as  represented  in  other  States.  We 
are  not  even  acquainted  with  the  actual  situation  as  it  exists  in 
our  public  schools.  For  example,  in  one  of  the  schools  in  Austin 
where  a  very  superficial  examination  of  the  students  has  been 
made,  it  is  found  that  some  ten  to  twenty  in  a  school  of  three  or 
four  hundred  students  are  either  very  backward  or  really  feeble- 
minded. Twenty  at  least  in  this  school  are  incapable  of  doing 
the  work  asked  of  them.  They  not  only  are  unable  to  do  the 
work  themselves,  but  their  presence  in  the  school-room  constitutes 


Care  of  the  Feeble-minded  and  Insane  in  Texas 


2] 


a  very  great  detriment  to  the  progress  of  the  other  students   in 
the  room. 

The  city  of  Houston  maintains  a  special  room  with  a  specially 
trained  teacher  in  charge,  for  some  of  the  feeble-minded.  The 
teacher  tells  me  that  they  have  many  more  applications  than  they 
can  admit.  By  the  use  of  the  Binet  tests  she  lias  demonstrated 
the  presence  of  fiftyr  others  in  the  schools  trying  to  make  their 
grades  and  failing  year  after  year.  Only  a  small  percentage  of 
the   examinations   asked   for   have   been   made.     The   Department 


Plate  IV. 
Class  with  their  Teacher  in  Special  Room  of  the  Rusk  School,  Houston,  Texas. 


of  Education  of  the  State  cannot  give  us  information  concerning 
the  prohable  extent  of  such  a  situation  as  described  above. 

Superintendent  Eddings,  of  the  Training  School  at  Gatesville, 
states  that  a  great  many  of  his  boys  are  distinctly  feeble-minded. 
The  State  supplies  no  means  for  the  proper  care  and  training  of 
these  delinquents,  either  through  the  public  school  system  or  at 
this  special  detention  home.  No  classification  has  been  made  so 
that  the  officers  may  know  the  training  and  education  proper  for 
the  different  students  in  this  school.     The  result  is  that,  however, 


22 


Bulletin  of  the  University  of  Texas 


careful  and  painstaking  the  superintendent  and  his  co-workers 
may  be,  they  are  wholly  unable  to  handle  the  situation  in  a 
scientific  and  satisfactory  manner.  Texas  is  at  present  making 
a  feeble  attempt  to  establish  a  similar  school  for  delinquent  girls. 
The  last  United  States  census  report  gave  3,896,542  as  the 
population  of  the  State  of  Texas.  The  estimated  increase  in  the 
feeble-minded  population  per  decade  as  shown  by  the  census  re- 
ports is  considerably  over  20  per  cent.  The  Eoyal  Commission 
on  the  Feeble-minded  in  England  reported  that  the  feeble-minded 
population  increased  twice  as  rapidly  as  the  normal  population 
increased.  If  this  were  true  in  Texas  we  should  have  consider- 
ably over  10,000  feeble-minded  children  and  adults  in  the  State. 
If  we  take  a  far  more  conservative  basis  for  rural  and  urban  com- 
munities, one  in  650,  Texas  would  have  at  least  5000.  This  is 
unquestionably  too  low.  But  even  at  that  rate  we  have  in  Texas 
a  large  population  of  persons  who  are  not  only  under  present  con- 
ditions unable  to  support  themselves,  but  are  occupying  the  time 
and  productive  energies  of  at  least  an  equal  number  of  able-bodied 
adults.  This  is  by  no  means  the  only  clanger  involved.  On  the 
one  hand  it  may  be  purely  this  economic  question.  On  the  other, 
however,  it  concerns  the  attitude  of  approximately  5000  homes  in 
the  State,  and  social  and  moral  problems  whose  value  is  impossible 
of  determination. 


TABLE  SHOWING  INCREASE  OF  INSANE  AND  FEEBLE-MINDED  !N  TEXA> 


Date  of 
Census 

Population 
of  Texas 

Insane 
U.S.   Report 
Census 

State 
Asylum 
Report 

One  In- 
sane per- 
son to 

No.    per 
100,000 

Feeble- 
Minded 
U.   S.   Census 

1860 
1870 

604,215 
818,579 
1,591,749 
2,235,527 
3,048,710 
3,896,542 

125 

270 

1,564 

1,670 

50 

*135 

369 

1,045 

2,379 

4,053 

12,080 

*6,063 

4,313 

2,139 

1,281 

961 

7.9 

201 
451 

1880 
1890 
1900 

23. 
46.7 
78. 
104. 

2,276 

2,763 

*4 , 500 

1910 

*6,000 

♦Estimated,  as  no  statistics  are  available. 

The  United  States  discontinued  the  taking  of  a  census  of 
feeble-minded  after  1890.  It  was  found  impossible  to  get  any- 
thing like  accurate  results  as  many  families  did  not  know  and 
others  were  averse  to  stating  the  facts. 

In    1880,    they   found,    even   with    inaccurate   methods,    76,895 


Care  of  the  Feeble-minded  and  Insane  in  Texas  23 

feeble-minded  persons,  or  one  in  652.  In  1890,  they  found 
95,609,  or  one  in  655.  In  1908,  the  English  Royal  Commission 
reported  for  England  one  feeble-minded  person  in  217;  for  Scot- 
land, one  in  400;  for  Ireland,  one  in  175.  It  is  quite  probable 
that  they  failed  to  secure  a  full  census,  with  the  less  accurate 
methods  available  then.  A  municipal  census  taken  in  1910  in 
Philadelphia  gave  one  in  500  of  low  grade,  and  a  total  feeble- 
minded population  of  all  grades  of  one  in  140.  Another  test  in 
a  town  of  10,000  population  revealed  a  ratio  of  one  in  200.  "The 
field  workers  of  the  three  institutions  in  New  Jersey  have  been 
recording  cases  as  they  happen  to  find  them  in  the  communities 
where  they  are  studying  family  histories.  Within  the  year  (1911- 
1912),  they  have  reported  4121  cases  not  in  institutions.  There 
are  in  New  Jersey  institutions  1348,  with  393  on  waiting  lists, 
making  5865  recorded  cases  in  that  State."* 

Erom  the  above  we  see  that  in  New  Jersey,  where  a  partial 
survey  has  been  made,  the  ratios  of  feeble-minded  to  total  popu- 
lation is  more  than  one  in  500,  actually  one  in  432-|-,  this  of  the 
recorded  cases  alone. 

We  have  no  data  in  Texas.  The  last  census  taken  in  1890 
gave  the  State  2763.  If  we  estimate  on  the  basis  of  the  1890 
report  for  the  whole  United  States,  Texas  would  have  now  one 
in  655,  or  5948  feeble-minded.  If  we  accept  the  estimate  offered 
by  conservative  statisticians,  that  there  is  one  feeble-minded  to 
500  population,  Texas  has  now  over  7700  in  this  class.  John- 
stone's own  estimate  is  one  in  300,  or  12,988  in  Texas.  I  have 
placed  the  most  conservative  estimate  in  the  table  above. 

In  summarizing  the  statistics  on  the  feeble-minded  as  far  as 
they  can  be  gathered  throughout  the  United  States,  Alexander 
Johnson  states  that  there  are  probably  67,000  already  in  custody, 
distributed  about  as  follows :  In  institutions  for  the  feeble- 
minded, some  20,000;  in  almshouses,  about  16,000;  in  hospitals 
for  the  insane,  5000;  in  prisons  and  reformatories,  26,000.  This 
is  approximately  one-third  of  the  estimated  total  of  feeble-minded 
individuals  in  the  United  States. 

* Johnson  in  the  Survey,  March,    1912. 


24  Bulletin  of  the  University  of  Texas 


CAUSES    OF   FEEBLE-MIKDEDNESS. 

"The  study  of  the  etiology  of  idiocy  and  imbecility  assumes  a 
new  aspect  in  view  of  the  rapid  and  startling  growth  of  many 
phases  of  mental  defect,"  states  Ban*  in  his  book  on  Mental  De- 
fectives. The  discussion  of  causes  practically  resolves  itself  into 
the  question  as  to  the  relative  parts  played  by  heredity  and  en- 
vironment. They  may  be  divided  into  (1)  intrinsic  factors,  or 
those  which  modify  the  germinal  plasm  before  conception  takes 
place,  and  (2)  extrinsic  factors,  or  those  conditions  of  environ- 
ment which  affect  the  development  of  the  brain  (and  the  body) 
while  yet  within  or  without  the  uterus.  It  would  be  impossible 
to  assert  that  any  one  cause  is  the  supreme  agent  of  degeneration 
because  the  influences  of  heredity,  environment,  and  even  accident 
all  work  together  and  so  envelop  the  human  organism,  that  we 
cannot  separate  entirely  their  results. 

The  most  important  intrinsic  factors  which  cause  or  help  to 
cause  amentia  are  (1)  disease  of  the  nervous  system;  (2)  alcohol- 
ism, and    (3)    tuberculosis. 

The  Massachusetts  Commission  as  early  as  1848  reported  475 
idiots,  227  due  to  heredity  of  mental  defect,  direct  or  collateral. 
The  Connecticut  Commission  as  far  back  as  1856  found  idiocy 
running  in  families.  The  Illinois  State  Board  of  Public  Chari- 
ties in  1870  deplored  the  "association  of  sexes"  in  almshouses 
because  of  the  perpetuation  of  the  degenerate  of  the  race.  Dug- 
dale's  history  of  "the  Jukes"  family  shows  the  final  outcome  of 
varied  neuroses  when  fostered  by  heredity  and  environment  for 
more  than  100  years.  There  are  1200  people  descendants  of  five 
degenerate  sisters  who  repeat  in  successive  generations  disease, 
insanity,  idiocy,  and  crime.  Barr  says :  "In  these  we  have  surely 
found  evidence  in  support  of  the  theory  advanced,  that  the  trans- 
mission of  imbecility  is  at  once  the  most  insidious  and  the  most 
aggressive  of  degenerative  forces,  attacking  alike  the  physical, 
mental,  and  moral  nature,  enfeebling  the  judgment  and  will,  while 
exaggerating  the  sexual  impulses  and  the  perpetuation  of  an  evil 
growth,  a  growth  too  often  parasitic  ready  to  unite  with  any 
neuroses  it  may  encounter,  and  from  its  very  sluggishness  and 
inertia  refusing  to  be  shaken  off;  lying  latent  it  may  be,  but  sure 


Care  of  the  Feeble-minded  and  Insane  in  Texas  25 

to  reappear,  as  Haller  recounts,  through  a  century  to  the   fourth 

and   fifth  generation." 

Two  important  early  studies  of  groups  of  individuals  have  been 
made  according  to  the  case  history  method  of  research,  one  by 
Drs.  Beach  and  Shuttleworth  from  Warenth  and  the  Royal  Albert 
Asylums  in  England.  They  looked  into  some  two  and  one-half 
thousand  cases.  Barr  himself  compiled  the  other  from  various 
Records,  principally  the  Pennsylvania,  Training  School.  These 
two  compilations  agree  more  or  less,  putting  as  the  most  impor- 
tant period  the  one  before  birth;  of  second  importance  the  one 
after  birth,  and  of  least  importance  the  time  at  birth. 

We  quote  below  the  outline  and  percentages  of  feehle-minded- 
ness  due  to  the  different  causes  as  given  by  Church  and  Peterson.* 

HEREDITY. 

"The  consideration  of  human  heredity  .  .  .  must  always 
largely  be  from  the  statistical  side,  consisting  in  an  analysis  of 

(*)     Church  and  Peterson  Nervous  and  Mental  Diseases,  p.  876. 

f  1.     Hereditary  transformations  of  nervous  and  mental  diseases. 
I  2.     Pathological    heredity  in  the    form  of  vitiating  diseases  or  habits 
Degenerative     J  (tuberculosis,    rheumatism,     herpetism,     gout,      syphilis,     alco- 

holism, etc). 
Sociological  factors    (extreme  youth  or  parents  of  great  age;  dis- 
proportionate ages  of  parents;  consanguinity). 

[Maternal-disease,   trauma,   fright,   shock;   maternal   im- 
pressions. 


Adventitious      ■( 


Gestational  -J 

f  Syphilis,      heart      disease,      arteritis, 
I  Fetal    disorders     -j      morbid     processes     in     brain     and 
(      meninges,  twin  pregnancy. 

[  Difficult    labor,    primogeniture,    premature    birth,    as- 
Parturitional    {  phyxia    at    birth,    instrumental    deliveries,    pros- 

it sure  on  cord. 

f  Convulsions,    cerebral     diseases,    trauma    to    the    head, 
Postnatal    \  febrile   diseases,   mental  shock,   sunstroke,   overpres- 

{  sure  at  school. 

The  variations  in  the  importance  of  these  various  factors  as  estimated  by  different 
authorities  are  indicated  below: 

Neurotic  inheritance  in  between  forty  to  fifty  per  cent  of  idiots. 
Tuberculosis  and  scrofula  in  between  fifteen  to  thirty  per  cent  of  idiots. 
Alcoholism  in  between  nine  to  sixteen  per  cent  of  idiots. 
Syphilitis  in  between  one  to  two  per  cent  of  idiots. 
Gestational  in  between  eleven  to  thirty  per  cent  of  idiots. 
Parturitional  in  between  eighteen  per  cent  of  idiots. 
Infantile  convulsions  in  between  twenty-five  per  cent  of  idiots. 
Cerebral  diseases  in  between  eight  and  nine  per  cent  of  idiots- 

I  measles, 
scarlet  fever, 
diphtheria, 
whooping   cough, 
small  pox, 
{  typhoid  fever, 


in  six  per  cent  of  idiots. 


26  Bulletin  of  the  University  of  Texas 

experiments    already    performed    rather    than    in    initiating    new 
experiments. 

"Such  institutions  as  insane  asylums,  prisons,  sanitariums,  and 
homes  for  the  unfortunate  are  excellent  foci  for  studying  certain 
phases  of  human  heredity,  because  they  are  simply  convenient 
places  where  the  results  of  similar  experiments  in  genetics  have 
been  brought  together. 

EXPERIMENTS    IN    HUMAN    HEREDITY. 

a.     The  Jukes. 

"A  classic  example  of  an  experiment  in  human  heredity  which 
has  been  partially  analyzed  by  the  statistical  method  is  that 
furnished  by  Dugdale  in  1877  in  the  case  of  'Max  Jukes'  and  his 
descendants.  It  includes  over  one  thousand  individuals,  the  origin 
of  all  of  whom  has  been  traced  back  to  a  shiftless,  illiterate,  and 
intemperate  backwoodsman,  who  started  his  experiment  in  hered- 
ity in  western  New  York  when  it  was  yet  an  unsettled  wilderness. 

"In  1877  the  histories  of  540  of  this  man's  progeny  were  known, 
and  that  of  most  of  the  others  was  partly  known.  About  one- 
third  of  this  degenerate  strain  died  in  infancy,  310  individuals 
were  paupers,  who  all  together  spent  a  total  of  2300  years  in 
almshouses,  while  410  were  physical  wrecks.  In  addition  to  this, 
over  one-half  of  the  female  descendants  were  prostitutes,  and  130 
individuals  were  convicted  criminals,  including  seven  murderers. 
Not  one  of  the  entire  family  had  a  common  school  education, 
although  the  children  of  other  families  in  the  same  region  found 
a  way  to  educational  advantages.  Only  twenty  individuals 
learned  a  trade  and  ten  of  these  did  so  in  state's  prison. 

"It  is  estimated  that  up  to  1877  this  experiment  in  human 
breeding  had  cost  the  State  of  New  York  over  a  million  and  a 
quarter  dollars,  and  the  end  is  by  no  means  yet  in  sight. 

b.     The  Descendants  of  Jonathan  Edwards. 

"In  striking  contrast  to  the  case  of  Max  Jukes  is  that  of  Jon- 
athan Edwards,  the  eminent  divine,  whose  famous  progeny  Win- 
ship  described  as  follows :  '1394  of  his  descendants  were  identified 
in  1900,  of  whom  295  were  college  graduates;  13  presidents  of  our 


Care  of  the  Feeble-minded  and  Insane  in  Texas  27 

greatest  colleges,  besides  many  principals  of  other  important  edu- 
cational institutions;  60  physicians,  many  of  whom  were  eminent; 
100  and  more  clergymen,  missionaries,  or  theological  professors; 
75  were  officers  in  the  army  and  navy;  60  were  prominent  authors 
and  writers,  by  whom  135  books  of  merit  were  written  and  pub- 
lished and  eighteen  important  periodicals  edited ;  thirty-three 
American  States  and  several  foreign  countries  and  ninety-two 
American  cities  and  many  foreign  cities  have  profited  by  the 
beneficent  influence  of  their  eminent  activity;  100  and  more  were 
lawyers,  of  whom  one  was  our  most  eminent  professor  of  law; 
30  were  judges;  80  held  public  office,  of  whom  one  was  Vice  Presi- 
dent of  the  United  States;  three  were  United  States  Senators; 
several  were  Governors,  members  of  Congress,  framers  of  State 
Constitutions,  mayors  of  cities,  and  ministers  to  foreign  courts; 
one  was  president  of  the  Pacific  Mail  Steamship  Company;  fifteen 
railroads,  many  banks,  insurance  companies,  and  large  industrial 
enterprises  have  been  indebted  to  their  management.  Almost,  if 
not  every,  department  of  social  progress  and  of  public  weal  has 
felt  the  impulse  of  this  healthy,  long-lived  family.  It  is  not 
known  that  any  one  of  them  was  ever  convicted  of  crime.' 

c     The  Kallihak  Family. 

"A  more  convincing  experiment  in  human  heredity  than  the 
foregoing,  since  it  concerns  the  descendants  of  two  mothers  and 
the  same  father,  is  furnished  by  the  recently  published  history  of 
the  'Kallikak'  family. 

"During  Eevolutionary  days,  the  first  Martin  Kallikak — the 
name  is  fictitious — who  was  descended  from  a  long  line  of  good 
English  ancestry,  took  advantage  of  a  feeble-minded  girl.  The 
result  of  their  indulgence  was  a  feeble-minded  son,  who  became 
the  progenitor  of  480  known  descendants,  of  whom  143  were  dis- 
tinctly feeble-minded,  while  most  of  the  others  fell  below  medi- 
ocrity without  a  single  instance  of  exceptional  ability. 

"  ' After  the  Revolutionary  War  Martin  married  a  Quaker  girl 
of  good  ancestry  and  settled  down  to  live  a  respectable  life  after 
the  traditions  of  his  forefathers.  From  this  legal  union  with  a 
normal  woman  there  have  been  496  descendants.  All  of  these 
except  two  have  been  of  normal  mentality,  and  these  two  were  not 


28  Bulletin  of  the  University  of  Texas 

feeble-minded.  .  .  .  The  fact  that  the  descendants  of  both  the 
normal  and  the  feeble-minded  mother  have  been  traced  and  studied 
in  every  conceivable  environment,  and  that  the  respective  strains 
have  always  been  true  to  type,  tends  to  confirm  the  belief  that' 
heredity  has  been  the  determining  factor  in  the  formation  of  their 
respective  characters.'  " 
."4.     Moral  and  Mental  Characters  Behave  Like  Physical  Ones." 

"These  instances  of  human  breeding  show  unmistakably  that 
'blood  counts'  in  human  inheritance,  even  though  the  hereditary 
unit  characters  that  lead  to  these  general  results  have  not  yet 
been  analyzed  with  the  clearness  that  is  possible  in  dealing  with 
the  characters  of  some  animals  and  plants. 

"There  is,  of  course,  no  question  of  moral  and  mental  traits  in 
plants,  and  the  role  that  these  play  in  animals  is  not  easy  to 
determine;  but  in  man  the  case  is  undoubtedly  much  more  im- 
portant and  complex,  since  mental  and  moral  characteristics  have 
a  large  share  in  making  man  what  he  is.  There  is,  however,  no 
fundamental  scientific  distinction  which  can  be  drawn  between 
moral,  mental,  and  physical  traits,  and  they  are  undoubtedly  all 
equally  subject  to  the  laws  of  heredity. 

"For  instance,  as  an  illustration  of  the  hereditability  of  non- 
physical  traits,  in  the  Jukes'  pedigree  three  of  the  daughters  of 
Max  impressed  their  peculiar  moral  and  mental  characteristics  in 
a  distinctive  way  upon  their  offspring.  To  quote  Davenport : 
'Thus  in  the  same  environment,  the  descendants  of  the  illegitimate 
son  of  Ada  are  prevailingly  criminal;  the  progeny  of  Belle  are 
sexually  immoral;  and  the  offspring  of  Erne  are  paupers.  The 
difference  in  the  germplasm  determines  the  difference  in  the  pre- 
vailing trait.'  "* 

Morbid  heredity  seems  from  the  above  to  be  much  the  more 
important  factor  in  the  cause  of  mental  deficiency.  Tredgold  in 
his  investigations  found  amentia  thus  caused  in  80  per  cent  of 
the  cases ;  others  give  percentages  as  follows : 

Beach  and  Shuttleworth,  42  per  cent. 

Kock  of  Germany,  60  per  cent. 

Dr.  Caldicott,  70-75  per  cent. 

Connecticut  Commission,  60  per  cent. 

*Walter,  H.  E.,  Genetics,  etc.,  p.  226ff. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  29 

In  Switzerland   (Canton  of  Berne),  55  per  cent. 

Dahl  of  Norway,  50  per  cent. 

Tredgold  says  his  higher  percentage  is  probably  due  to  his  per- 
sonal inquiry,  most  of  the  others'  reports  are  gotten  from  informa- 
tion given  in  case-books  or  from  official  returns. 

OTHER   INTRINSIC    FACTORS. 

Alcoholism  is  given  second  importance  in  this  table,  though  in 
five-sixths  of  such  cases  neuropathic  heredity  was  present  as  well. 
Long-continued  excessive  indulgences  in  alcohol  impair  the  nerv- 
ous system  of  the  offspring,  and  make  it  less  capable  of  resisting 
other  harmful  influences.  Alcoholism  is  much  more  important  as 
a  contributory  agent  than  as  a  sole  cause.  The  same  is  true  of 
tuberculosis,  which  is  rarely  the  direct  cause  of  amentia,  but  is 
very  important  as  an  indirect  and  contributory  influence.  Its 
indirect  effect  is  seen  in  its  undoubted  tendency  to  produce  nervous 
instability  in  the  offspring.     Tredgold  says  in  this  connection : 

"I  regard  these  three  morbid  ancestral  conditions,  namely: 
disease  of  the  nervous  system,  alcoholism,  and  consumption,  as 
being  far  and  away  the  most  frequent  causes  of  mental  defect. 
The  two  latter  appear  to  me  to  be  rather  remote  than  immediate 
in  their  action,  their  effect  being  to  initiate  the  neuropathic 
diathesis,  which,  if  unchecked,  eventually  culminates  in  amentia." 

Barr  is  personally  of  the  opinion  that  intemperance  as  a  factor 
is  overrated,  although  given  more  than  16  per  cent  in  the  English 
table  and  more  than  -i  per  cent  in  the  American.  Ireland  acknowl- 
edges the  poisoning  effect,  but  would  rather  diminish  the  usual 
percentage  given.  Howe  found  nearly  50  per  cent  offsprings  of 
drunkards.  Barr  found  eight  striking  examples  of  such  an  hered- 
ity. In  Mechanics'  Institution  at  Manchester,  England,  are  casts 
of  seven  microcephalic  idiots,  all  conceived  in  drunkenness.  Later 
the  father  became  a  sober  man,  and  to  him  was  born  a  perfect 
child. 

Fere  says  no  neuropathic  disease  is  more  directly  transmitted 
than  epilepsy,  but  statistics  do  not  show  it  such  an  important 
factor  except  in  combination  with  some  other  disease  as  insanity. 
Barr  found  little  more  than  3  per  cent;  Eogers,  1  per  cent;  Down, 
9  per  cent;  Beach  and  Shuttleworth,  8  per  cent;  Kerlin,  16  per 


30  Bulletin  of  the  University  of  Texas 

cent;  doubtless  in  combination  with  other  neuroses.  Barr  con- 
siders it  as  much  a  phase  as  a  contributing  cause— an  abnormal 
condition  in  which  mental  deterioration  is  constantly  going  on 
though  often  unrecognizable  before  death  comes. 

The  minor  neuroses  such  as  hysteria,  headaches,  fits  of  anger, 
give  a  weakened  power  of  resistance,  a  lowering  of  moral  tone,  and 
with  other  neuroses  are  sure  to  develop  idiocy  or  feeble-minded- 
ness  in  the  long  run.  In  the  Farr  family  as  traced  by  Barr,  the 
father,  fairly  intelligent,  the  mother,  flighty,  nervous;  of  the  seven 
children,  three  sons  and  one  daughter  were  normal,  the  others 
imbeciles.  All  four  normal  children  married  normal  people,  but 
were  parents  of  one  or  more  imbeciles  in  each  case — evidently  a 
neurotic  taint. 

Consanguinity  is  held  by  only  a  few  to  be  a  cause  of  feeble- 
mindedness unless  associated  with  some  hereditary  taint.  Down 
is  quoted  as  saying  "he  did  not  know  whether  the  race  might  not 
be  improved  by  a  judicious  selection  of  cousins."  In  Batz  feeble- 
mindedness is  said  to  be  unknown,  although  it  is  an  isolated  place, 
where  the  inhabitants  have  intermarried  for  generations.  Bouxsall 
reports  the  same  of  North  Greenland.  Scrofula,  cancer,  goitre,  and 
diseases  of  the  cardio-vascular  system  show  in  a  small  percentage 
of  feeble-mindedness.  They  are  usually  predisposers  rather  tban 
direct  causes  in  that  they  tear  down  and  weaken  the  system  gen- 
erally. Ireland  finds  few  cases  due  directly  to  syphilis.  Down 
and  Kerlin  found  2  per  cent  each;  Beach  and  Shuttleworth,  1.17 
per  cent;  Barr,  0.2  per  cent.  Numbers  of  frightful  examples  are 
given,  however,  of  idiotic,  paralyzed,  mute,  and  blind  offsprings 
of  a  father  who  has  syphilis. 

EXTRINSIC    OR    ADVENTITIOUS    CAUSES. 

Barr  believes  that  influences  retarding  or  complicating  delivery 
are  rather  insignificant  in  comparison  with  those  acting  before  or 
after  birth.  Premature  births  are  given  3.52  per  cent  in  the  Eng- 
lish table;  1.12  per  cent  in  the  American  table.  Difficult  labor 
was  found  more  influential  by  Beach  and  Shuttleworth,  14.24  per 
cent.  Bogers'  percentage  was  small  (as  was  Barr's),  but  the  lat- 
ter says  that  prolonged  detention  or  abnormal  pressure  doubtless 
play  a  role  in  the  etiology  of  mental  deficiency.     Accidents  at  birth, 


Care  of  the  Feeble-minded  and  Insane  in  Texas  31 

such  as  death  of  the  mother,  or  injuries,  may  he  causes,  Barr 
thinks,  hut  the  percentage's  run  low  from  a  small  fraction  to  1.58 
per  cent,  as  given  by  Beach  and  Shuttleworth.  In  causes  acting 
after  birth,  the  English  table  gives  first  importance  to  eclampsia; 
the  American  to  injuries  to  the  head,  both  tables  approaching  6 
per  cent  in  the  latter  cause,  which  may  result  in  concussion  di- 
rectly or  later  by  the  occurrence  of  a  secondary  lesion.  Down  and 
Rogers  are  of  the  opinion  that  many  cases  of  congenital  origin 
are  attributed  to  fatts.  Acute  diseases,  febrile  illnesses,  are  given 
5.96  per  cent  by  Beach  and  Shuttleworth;  22  per  cent  by  Rogers; 
but  often  a  latent  predisposition  is  thought  to  be  the  cause  of  the 
lack  of  resisting  power.  Meningitis  and  scarlet  fever  are  given 
as  quite  important  factors  by  Rogers,  Down,  and  Barr. 

Tredgold  believes  strongly  in  the  abnormal  physical  condition 
of  the  mother  as  an  important  etiological  factor.  Poor  nutrition 
and  lowered  vitality  of  the  mother  are  quite  serious  conditions  for 
the  offspring.  The  alcoholic  mother  may  vitally  effect  the  child. 
Fere  of  Paris  showed  by  experiment  the  effect  of  vapour  of  alcohol 
upon  incubating  eggs.  Sixteen  per  cent  were  incompletely  de- 
veloped; 21  per  cent  were  monstrosities  of  idiotic  grade.  Absinthe 
was  even  more  fatal  in  its  effect.  Tredgold  thinks  here  is  the 
importance  to  be  attached  especially  to  tuberculosis  and  syphilis — ■ 
the  lowered  vitality  of  the  mother.  Watt  on  Heredity  and  Dis- 
ease in  the  British  Medical  Journal  of  October,  1905,  says  un- 
doubtedly many  more  weak-minded  ones  would  result  from  syphilis 
"were  it  not  for  the  very  high  rate  of  sterility,  miscarriages,  still- 
horn,  and  short-lived  offspring  that  it  produces."  From  Tredgold 
we  have  the  following  statement: 

"What  I  wish  to  point  out,  moreover,  is  that  as  far  as  my 
experience  goes,  injurious  external  factors  of  themselves  but  rarely 
give  rise  to  mental  defect,  and  when  they  do  so,  it  is  usually 
because  they  have  produced  a  gross  lesion  of  the  brain." 

From  a  consideration  of  the  above  statistics  and  statements  made 
by  men  who  have  made  a  lifelong  study  of  mental  deficiencies,  I 
am  sure  that  we  can  conclude  that  defects,  both  mental  and  phys- 
ical, are  found  in  families  and  in  generation  after  generation  when 
the  defect  once  appears.  Natural  experiments  are  so  far  our  only 
basis  for  such  conclusions  in  human  beings,  but  the  data  there  is 


32  Bulletin  of  the  University  of  Texas 

overwhelming  and  no  one  conversant  with  the  facts  dares  ignore 
the  terrible  risks  involved  in  neglecting  to  obey  the  lessons  taught. 
As  said  above,  we  cannot  experiment  directly.  The  problem  must, 
therefore,  be  a  social  and  governmental  one.  State  and  national 
authorities  must  combine  to  produce  convincing  data  and  to  reach 
fullv  established  facts.  Ignorance  of  the  conditions  that  surround 
our  criminals  in  the  making  and  of  the  origin  of  our  "submerged 
tenth"  is  more  culpable  than  neglect  and  harsh  treatment.  Cen- 
ters of  vice  and  crime  are  not  to  be  found  in. our  cities  alone.  In 
the  country  are  produced  many  of  those  who  will  fill  our  jails 
and  almshouses;  there  are  to  be  found  the  nucleus  that  will  pro- 
duce future  thousands  of  degenerates  and  defectives  and  cost  the 
State  millions  of  dollars  in  police  courts  and  prisons.* 

Statistics  of  the  Eoyal  Commission  show  that  insanity  is  more 
-characteristic  of  urban  and  industrial,  and  amentia  of  rural  popu- 
lations. The  causes  of  these  two  conditions  are  identical  in  kind, 
namely:  morbid  neuropathic  heredity  (but  heredity  is  slightly 
more  pronounced  in  amentia  than  in  insanity).  In  the  majority 
of  cas*es  of  amentia  in  the  slams  there  is  decided  morbid  heredity 
present,  and  their  environment  is  not  the  cause  but  the  result  of 
that  heredity.  They  are  at  great  disadvantage  in  earning  their 
living,  and  are  so  careless,  improvident,  and  intemperate  that  they 
waste  what  little  money  they  earn. 

People  of  most  initiative  and  enterprising  qualities  move  to 
cities,  leaving  those  of  less  mental  vigor  content  to  remain  upon 
the  soil.  By  intermarriage  morbid  heredity  is  accumulated,  and 
thus  conditions  in  these  areas  become  more  and  more  favorable 
to  the  production  of  actual  mental  defect.  On  the  other  hand, 
in  our  densely  crowded'  industrial  centers,  where  competition  is 
keen,  the  stresses  of  life  are  severe,  alcoholism  is  rife,  consump- 
tion is  prevalent,  and  all  the  unfavorable  social  and  economic  con- 
ditions are  present  to  produce  an  instability  of  the  higher  parts 
of  the  nervous  system — the  precursor  of  insanity.  This  in  later 
generations  leads  to  actual  defect  of  structure  and  consequent 
amentia,  but  the  constant  immigration  brings  fresh  blood  into  the 
vortex  and  tends  to  make  insanity  rather  than  amentia  the  pre- 
vailing type  of  mental  abnormality. 

"See  report  on  Bell  county,   p.   109. 


Care  of  Hip  Feeble-minded  and  Insane  in  Texas 


THE  DEFECTIVE  IN  SOCIETY. 

Criminal  and  Anti-Social  Tendencies.  —  It  cannot  be  repeated  too 
often  or  emphasized  too  much  that  the  sum  total  of  disease,  pov- 
erty, crime,'  immorality,  degraded  standards  of  living,  worry  and 
distress  in  society  is  beyond  the  power  of  man  to  estimate;  and 
that  it  is  clearly  traceable  to  perverted  ideas  and  ideals  on  the  one 
hand ;  to  the  absence  of  any  ideas  and  ideals  at  all,  and  to  mal- 
adjusted energies  used  in  putting  ideas  into  action,  on  the  other. 
The  instinct  of  possession  and  an  abundance  of  energy  may  make 
the  kleptomaniac  or  the  "'respected'"  citizen;  abundance  of  phys- 
ical energy  and  the  mind  of  the  child  or  that  of  the  moral  im- 
becile may  produce  tbe  woman  of  the  street  and  the  male  pervert. 
The  school-room  with  fifty-nine  interested  normal  children  becomes 
a  whirl  of  confusion  through  the  sixtieth  child  whose  love  for 
money,  pencils,  or  food,  is  greater  than  her  memory  for  punish- 
ment or  whose  regard  for  others  is  yet  unawakened.  The  good- 
natured  imbecile,  the  utterly  helpless  idiot,  the  easily  pleased  and 
happy  insane  present  the  State  and  the  home  with  the  simple 
problem  of  watchful  protection  amidst  clean,  hygienic  surround- 
ings with  amusements  and  occupations  suited  to  their  abilities  and 
interests.  The  defective-delinquent  breeds  trouble  always  and 
everywhere  he  goes  unless  his  mind  and  body  are  fully  occupied 
and  under  custodial  care  or  personal  guardianship. 

Referring  to  the  defective-delinquents,  and  more  especially  to 
the  female  delinquent,  Mr.  Johnson  states  that  a  large  percentage 
of  our  girls  who  go  wrong  are  of  the  defective,  or  feeble-minded, 
class.  Statistics  from  a  number  of  the  institutions  where  such 
girls  are  detained  seem  to  prove  this  contention.  For  example, 
the  New  York  reformatory  at  Elmira  finds  37  per  cent  of  its 
inmates  clearly  feeble-minded;  the  New  Jersey  reformatory  at 
Rahway,  33  per  cent ;  the  New  York  Reformatory  for  Women  at 
Bedford,  37  per  cent;  tbe  Massachusetts  Industrial  School  for 
Girls  at  Lancaster,  50  per  cent;  the  Maryland  Industrial  School 
for  Girls,  Baltimore,  60  per  cent,  and  the  State  Home  for  Girls, 
Trenton,  New  Jersey,  33  per  cent.* 

*  Johnson,  Alexander,  American  Year  Book,   1913,  p.  440. 


34  Bulletin  of  the  University  of  Texas 

In  the  United  States  on  the  basis  of  one  in  300,  there  are 
307,185  feeble-minded.*  This  is  a  lower  rate  than  that  adopted 
by  the  English  commission.  Goddard  states  that  "Three  hundred 
thousand  persons  in  the  United  States  are  feeble-minded,  and  five 
hundred  thousand  persons  in  the  United  States  have  not  sufficient 
intelligence  to  manage  their  own  affairs  with  ordinary  prudence — 
are  unable  to  compete  with  their  fellows  on  equal  terms  and  thereby 
to  earn  livelihoods.  A  still  larger  number  have  not  sufficient  will 
power  to  force  themselves  to  do  the  right  thing  when  it  is  pointed 
out  to  them."f  Sixty  thousand  of  these  are  feeble-minded  women 
of  child  bearing  age.  Fifty  per  cent  of  the  prostitutes  are  morons, 
or  decidedly  feeble-minded.  This  percentage  is  probably  too  low. 
We  quote  below  the  results  of  the  Binet  tests  applied  to  one  hun- 
dred young  women  admitted  to  the  Bedford  Hills  Reformatory, 
New  York  State.  The  selection  is  practically  serial  admission. 
The  physical  age  ranged  from  sixteen  to  twenty-nine  years. \ 

Number  in 
Mental  Age  by  Binet  Scale.  Group. 

5  to     6  years 1 

7  to     8  years 3 

8  to     9  years 8 

9  to  10  years 29 

10  to  11  years 39 

11  to  12  years 19 

12  years   1 


100 


Average  mental  age,  10.05  years;  average  fundamental  year, 
7.54.  years;  average  physical  age,  20  years  9.7  months. 

If  these  tests  even  approximately  measure  their  mentality,  "these 
young  women  with  the  physiques,  the  strength,  the  appetites,  and 
the  passions  of  grown  women,  with  their  experiences  of  the  life 
of  the  underworld,  have  only  the  average  age  of  little  girls  of 
ten  to  guide  their  lives."** 

*Folks,  Homer,  Conf.  C.  k  C,  1911,  p.  2. 

t-Johnson,  Alexander,  American  Year  Book,  1913,  p.  440. 

JSee  p.  62  for  description  of  Binet  tests. 

**Davis,  K.  B.,  The  Survey,   1911-12,  p.   1851. 


Care  of  the  Feeble-mMided  and  Insane  in  Texas  35 

THE  MENTALITY  OF  THE  PROSTITUTE 


Examined  at — 

Totals 

Prisons 

Detention 

House 

awaiting 

trial 

Industrial 
Schools 

Per 
Cent 

54 

4 
42 

46 
54 

54 

7 
39 

1 51 

11 

135 

51 

3 

45 

Total 

100 

100 

100 

300 

"The  mental  inferiority  of  many  of  these  women  was  masked 
by  the  glibness  of  tongue,  the  bold  and  confident  manner  and  the 
attractive  physical  appearance  which  are  so  often  found  in  such 
cases.  The  general  appearance  and  bearing  of  many  would  not 
suggest  feeble-mindedness  to  an  inexperienced  observer.  .  .  . 
The  135  women  designated  as  normal  as  a  class  were  of  distinctly 
inferior  intelligence — drunken,  alcoholic,  and  drug-stupefied  women 
were  all  classified  as  normal.  Not  more  than  six  of  the  entire 
number  seemed  to  have  really  good  minds."* 


CHILDREN    OF   SCHOOL   AGE. 

The  statistics  quoted  above  in  various  places  are  admittedly 
inexact.  Medical  inspection  in  the  schools  is  established  in  very 
few  States,  and  many  of  the  States,  including  Texas,  have  no 
agency  studying  the  problems  of  the  backward  and  delinquent 
child,  or  adult.  In  California,  where  medical  inspection  is  in  oper- 
ation in  the  schools,  thousands  of  remediable  cases  of  backward 
children  and  actually  feeble-minded  ones  have  been  found  where 
none  were  reported.  Out  of  18,000  children  tested,  13,000  showed 
defects  that  were  more  or  less  remediable.  We  can  be  certain  that 
more  careful  study  and  more  accurate  methods  of  examination  will 
in  no  way  lower  these  various  estimates.  All  older  communities 
show  greater  percentages  of  these  classes.  Texas  cannot  hope  to 
see  a  different  outcome  if.  she  fail  to  appreciate  the  problem  or 
delay  the  means  for  its  solution-. 

As  illustrative  of  the  types  referred  to  above  and  the  problems 

*Report  of  the  Commission  for  the  Investigation  of  the  White  Slave 
Traffic,  so  called.     Boston,  February,  1914,  pp.  28-30. 


36 


Bulletin  of  the  University  of  Texas 


discussed  later,  the  writer  has  selected  at  random  a  number  of 
descriptions  of  cases  given  by  Barr  in  his  work  on  Mental  Defec- 
tives. Every  one  of  the  cases  given  might  easily  be  paralleled  by 
cases  taken  from  our  Texas  towns  and  villages  were  the  data  at 
hand  in  some  central  agency.  In  a  general  paper  of  this  sort  it 
does  not  seem  wise  to  refer  to  particular  communities  and  individ- 
ual families  in  Texas. 

Case  E. — B.  W.     Boy;  fourteen  years  old.     Under  training  be- 


•MOft/W.  IMBECILES—  LOW-GRADE. 


Plate  V. 

came  quite  efficient  in  household  service;  but  disobedient,  hard  to 
manage,  and  an  incorrigible  thief,  stole  even  from  himself.  Thus, 
some  years  ago  he  came  in  possession,  to  his  great  delight,  of  a 
toy — a  little  rubber  toad.  In  a  few  minutes,  however,  the  toy 
disappeared.  He  screamed,  cried,  and  protested  that  someone  had 
stolen  it.  Upon  investigation  it  was  discovered  securely  tucked 
away  in  his  glove.  He  had  secreted  it — stolen  it  from  himself — 
simply  to  create  excitement. 

B.  was  born  at  full  term :  ordinarv  labor.     There  were  four  or 


Care  of  the  Feeble-minded  and  Insane  in  Texas  37 

five  children;  two  sisters  living;  one  boy  nexl  older  than  \l..  an 
idiot,  was  killed  by  the  cars.  Mother,  imbecile,  forty-five  when 
child  was  born;  father,  a  day  laborer,  age  unknown.  Mother  had 
two  feeble-minded  sisters,  one  of  whom  had  an  illegitimate  feeble- 
minded son,  whose  father  was  also  feeble-minded. 

Case  H. — G.  A.  Boy,  aged  ten  years  when  photograph  was 
taken.  An  adroit  thief,  an  accomplished  liar,  brutal,  cruel,  and 
dangerous  to  smaller  boys.  In  training  class  Learned  to  knit  and 
darn  stockings.  Was  very  deft  with  hands,  but  too  dangerous  a  char- 
acter to  be  trusted  with  tools.  Could  pick  any  lock.  Under  super- 
vision was  fairly  good  at  both  farm  and  housework.  Enticed  away 
at  eighteen  years,  he  disappeared  for  five  years  and.  drifting  from 
farm  to  farm,  giving  unlimited  trouble,  finally,  in  a  spirit  of 
revenge,  set  fire  to  a  barn  and  was  arrested.  During  trial  he  con- 
fessed to  no  less  than  fifty  burglaries,  many  of  which  had  for  a 
long  time  baffled  the  detectives.  A  waif  atid  stray;  nothing  is 
known  of  family  history. 

Case  B. — L.  K.  Girl,  aged  fourteen  years  when  photograph  was 
taken.  Came  to  the  Training  School  in  her  sixth  year.  An  at- 
tractive child  with  blue  eyes  and  yellow  hair.  Willful  and  obsti- 
nate at  first,  but  soon  responded  to  influence.  Quick  to  imitate; 
did  well  in  kindergarten,  and  later  in  school  learned  to  read  and 
write,  to  sew  and  embroider,  but  began  to  deteriorate  morally,  and 
after  her  eighth  year  never  ceased  to  give  trouble.  Using  her 
acquirements  for  evil  purposes,  she  was  at  sixteen  a  thief,  a  liar, 
and  a  nymphomaniac  who  could  not  be  trusted  alone,  and  would 
pass  notes  to  boys  in  the  most  ingenious  fashion.  An  expert  in 
thieving,  she  could  lie  with  the  most  unblushing  effrontery  and 
apparent  innocence.  Could  be  clean  in  speech  and  circumspect  in 
conduct,  but  at  times  in  both  language  and  action  was  most  vile. 
Had  wonderful  influence  over  girls  of  lower  grade  and  used  them 
as  tools.  In  her  twenty-fifth  year,  having  grown  to  be  an  attrac- 
tive and  even  handsome  young  woman,  she  was  yet  so  unmanage- 
able that  she  was  transferred  to  an  insane  hospital.  From  there, 
through  the  ill-advised  efforts  of  some  sentimental  philanthropists, 
she  was  released  with  the  idea  that  she  was  capable  of  self-support. 
Since  then  she  has  drifted  naturally  downward,  and  having  given 
birth  to  an  illegitimate  child,  is  now  in  the  syphilitic  ward  of  a 


38 


Bulletin  of  the  University  of  Texas 


MORAL.  IM8£C(L£S  —  HIGH-GRAOE. 


Plate  VI. 


Care  of  the  Feeble-minded  and  Insane  In  Texas 


39 


charity  hospital.  Father,  a  blacksmith,  forty-one  years,  and 
mother,  an  imbecile  domestic,  thirty  years  of  age  at  time  of  child's 
birth.  Father  brutal,  abused  and  beat  unit  her.  who  was  a  victim 
also  of  overwork,  suffered  intense  pain  two  weeks  prior  to  child's 
birth.  Labor  long  and  difficult.  Both  parents  drunkards,  as  were 
also  both  grandfathers.  Maternal  grandfather  had  an  imbecile 
sister.* 

Case  E. — Mi.  C.     Female,  aged  twenty-three  years.     Eigh  grade. 
Came  under  my  care  when  nine  years  old.     Choreic  movements  of 


CRANIECTOMY. 


Plate  VII. 

face,  powers  of  attention,  imitation,  and  memory  excellent.  Could 
read  and  write,  sing,  distinguish  color  and  form  and  care  for  her- 
self in  every  way.  Did  well  in  school,  but  affected  and  silly  at 
times.  Mental  limit  reached  at  fifteen,  when  she  became  a  pro- 
nounced nymphomaniac ;  formed  violent  attachments  for  girls,  and 
was  fond  of  attracting  the  attention  of  boys.  In  her  seventeenth 
year,  her  mother  being  persuaded  that  imbecility  eould  be  cured, 


*For   a  description   of  other  eases  on   this  plate,  see  Barr,   op.  cit.,   pp. 
275ff.  l  ll 


40  Bulletin  of  the  University  of  Texas 

craniectomy  was  performed.  Exhibited  as  a  phenomenon  in  the 
hospital,  and  tributes  paid  to  the  surgeon's  wonderful  skill,  there 
was,  nevertheless,  not  the  slightest  improvement  in  her  condition. 
First-born,  at  full  term;  instrumental  delivery.  Father,  a  drunk- 
ard, was  forty-two,  and  mother,  forced  to  leave  him  in  the  fifth 
month  of  her  pregnancy,  was  eighteen  at  time  of  M.'s  birth.  Pater- 
nal grandfather,  a  drunkard,  died  of  cancer  of  the  mouth. 

Case  F. — F.  E.  Boy,  aged  eleven  years.  Epileptic.  High 
grade.  Coming  to  me  at  age  of  seven  years,  immediately  after 
an  operation  of  linear  craniectomy;  he  was  a  bright-faced,  attrac- 
tive boy,  with  black  eyes  and  hair;  erect  and  good  physique. 
Speech,  sight,  and  hearing  perfect.  Affectionate,  truthful,  obe- 
dient, tidy  in  dress,  cleanly  in  habits.  Table  manners  excellent. 
Understood  language  and  had  a  fair  vocabulary.  Powers  of  imi- 
tation and  memory  good,  but  attention  poor.  Knew  nothing  of 
color,  form,  or  number.  Upon  entering  the  kindergarten  was  in- 
clined to  be  a  little  slow,  but  when  stimulated  responded  and  be- 
came eager  to  learn.  Sense  of  perception  developed  rapidly. 
Peadily  recognized  articles  by  touch.  Developed  an  excellent  sing- 
ing voice.  Learned  to  march  and  dance  gracefully.  Passionately 
fond  of  music  and  animals,  learned  to  read,  write,  to  draw  and 
model  in  clay.  In  his  ninth  year  there  was  a  sudden  change  in 
his  moral  nature.  .Became  stubborn,  disobedient,  untruthful,  and 
kleptomaniac,  stealing  articles  for  which  he  had  no  use,  covering 
up  his  tracks  with  the  utmost  cleverness.  He  began  to  grow  silly 
and  there  was  a  recurrence  of  epileptic  attacks,  from  which  there 
had  been  immunity  for  five  years.  There  was  a  marked  change 
also  in  mental  condition,  and  he  would  sit  listless  or  aimlessly 
scribbling  on  slate  or  paper.  Within  two  years,  as  spasms  grad- 
ually decreased  and  finally  ceased,  he  emerged  from  this  lethargy 
and  returned  to  his  former  condition — moral  and  mental.  His 
improvement  I  consider  due  to  the  cessation  of  the  spasms,  train- 
ing and  treatment,  and  to  the  individual  care  he  has  received.  I 
can  see  no  benefit  traceable  to  the  craniectomy.  Fourth-born,  full 
term;  labor  ordinary.  Apparently  normal  when  born;  had  sev- 
eral falls  during  infancy,  but  nothing  unusual  was  noticed  until 
at  twelve  months,  after  an  attack  of  whooping  cough  he  appeared 
peculiar,  and  at  three  years  developed  epilepsy.     Father,  a  stone- 


Care  of  the  Feeble-minded  and  Insane  in  Terns  41 

cutter,  was  thirty-seven;  mother,  twenty-nine  when  F.  was  born. 
Family  history  excellent. 

Case  B. — XK.  Specially,  music.  Boy;  high  grade;  seventeen 
years  old.  Pleasing  address  and  courteous  manners.  Has  a  won- 
derful talent  for  music ;  plays  equally  well  on  piano  and  pipe-organ, 
either  at  sight  or  by  memory,  and  improvises  and  composes  with- 
out effort.  Has  had  the  benefit  of  a  course  in  music  at  a  European 
conservatory-  Is  an  apt  translator  of  foreign  languages.  Has 
wonderful  hand-skill,  which  he  is  capable  of  utilizing  as  purpose 
of  the  moment  demands.  Is  an  excellent  typewriter  and  accurate 
above  the  average.  From  his  tenth  year  he  had  attended  various 
schools  without  receiving  the  discipline  which  his  needs  required. 

Case  C. — L.  W.  Specialty,  hand  weaving.  Male;  twenty-nine 
years  old;  idio-imbecile.  A  mute;  other  senses  normal.  Under- 
stands everything  that  is  said  to  him,  and  makes  peculiar  grunt- 
ing noises  in  his  efforts  for  speech.  Could  not  learn  to  read  and 
write,  but  is  very  deft  with  his  fingers,  weaving  very  rapidly  intri- 
cate patterns,  with  colored  worsteds.  Second  child;  born  at  full 
term ;  nourished  by  mother ;  was  apparently  healthy  until  one  year 
old,  when  spasms  developed,  of  which,  however,  there  has  been  no 
recurrence.  Father,  a  farmer,  slow  of  speech  and  action;  was 
thirty-seven,  and  mother,  who  has  a  small  goitre,  was  twenty-eight 
at  time  of  child's  birth.     Both  parents  mentally  below  par. 

Case  D. — J..  I.  Specialty,  lightning  calculation.  Boy;  high 
grade  :  fifteen  years  old ;  epileptic,  spasms  recurring  monthly.  Can 
read  and  write,  and  is  fond  of  music  and  animals.  A  mathematical 
phenomenon ;  has  wonderful  facility  with  numbers.  Can  multiply, 
divide,  add,  and  subtract  as  rapidly  as  numbers  are  called.  When 
fatigued,  or  for  several  hours  succeeding  a  spasm,  he  does  this  very 
slowly,  or  not  at  all,  but  when  fresh  and  in  good  condition,  can 
calculate  very  rapidly,  giving  results  almost  simultaneous  with  the 
speaker's  voice.    Born  at  full  time ;  labor  ordinary. 

Case  E. — A.  E.  Specialty,  music.  Male;  idio-imbecile;  epi- 
leptic, thirty  years  old.  A  dwarf;  height  4  feet  1-J  inches;  weight, 
667}  pounds.  Physiologic  age,  about  sixty;  psychologic  age,  ten 
years — a  young  man  with  an  old  body  and  a  childish  mind. 

Vocabulary  and  understanding  very  limited,  but  has  a  wonderful 
ear  for  music.     Can  catch  any  tune  he  has  heard  once,  reproducing 


42 


Bulletin  of  the  University  of  Texas 


L.->  '.'-flBk 


i  SA'/AN 


Pl.vte  VIII. 


Care  of  the  Feeble-minded  find  Insane  in  Texas 


i:; 


it  accurately  on  the  mouth  organ.  Can  pick  out  tunc-  on  a  toy 
piano,  and  enjoying  Id's  own  performance  immensely,  will  applaud 
himself  vociferously,  clapping  his  hands  and  shouting  with  glee. 
Could  never  learn  to  read  or  write,  and  is  unable  even  to  dress 
himself.  Spasms  occur  not  oftener  than  once  a  year.  bu1  are  very 
severe.     Born  at  full  term;  ordinary  labor.     A  crying  infant,  was 


Plate  IX. 

Idiots  at  the  Dallas  county  poor  farm.  The  mental 
age  of  two  of  them  is  little  more  than  that  of  a  baby 
eight  or  nine  months  old.  They  are  allowed  to  form 
all  sorts  of'  habits,  and  are  cared  for  here  by  an  old 
negro  woman,  who  feeds  them  out  of  tin  pans  as  we 
feed  our  dogs  and  cats.  We  must  remember  that  these 
people  did  not  come  into  the  world  of  their  own  choice. 
They  must  live  in  it  now. 

dosed  largely  with  so-called  "soothing  syrups."  Had  meningitis 
and  did  not  walk  until  sixth  year.  Father,  a  clay  laborer,  prob- 
ably syphilitic;  mother  scrofulous  and  subject  to  "sick  headaches." 
Both  grandfathers  were  drunkards.  Paternal  grandmother  and 
father  had  each  a  sister  feeble-minded. 

Tire   children   described  here  illustrate  types  that  are  common 


4A  Bulletin  of  the  University  of  Texas 

everywhere,  including  Texas.  They  are  unmanageable  at  home 
and  in  the  ordinary  school,  a  source  of  continual  annoyance  to 
the  community.  We  people  our  jails,  poor  farms,  reformatories, 
and  prisons  with  them  finally.  The  training  school  and  colony 
with  their  special  means  for  care  and  control  have  proved  to  be 
the  best  place  for  such  defectives  throughout  life.  The  cases  cited 
are  actual  inmates  of  such  institutions  and  as  such  they  are  happy, 
useful  members  of  the  institution.  Plates  I,  II,  III,  IX,  etc.,  show 
how  we  treat  most  of  these  in  Texas.  Plate  IV  is  a  bright  spot  in 
our  own  State. 

THE  PROBLEM  AND  ITS  SOLUTION. 

It  would  be  impossible  to  show  the  difficulties  in  the  school-room 
where  such  feeble-minded,  or  low  grade,  backward  children  are 
found.  We  can  scarcely  estimate  in  any  satisfactory  way  the 
effect  upon  the  teacher  who  has  to  handle  such  a  child — the  effect 
upon  the  normal  child  who  must  remain  in  the  room  with  the 
nervous,  irritable,  or  disagreeable  person  of  this  type.  We  know 
from  investigations  in  other  States,  like  New  Jersey  and  Pennsyl- 
vania, that  a  large  portion  of  the  energy  and  efforts  of  the  teacher 
must  be  expended  on  such  a  child  to  produce  any  results  what- 
ever. So  great  has  become  this  problem  in  the  larger  cities  that 
many  of  them  have  established  separate  schools  for  the  unusual, 
or  defective  and  delinquent.  The  State  of  Texas,  local  or  general, 
has  made  with  one  exception  absolutely  no  provision  for  this  class 
cf  children  and  young  people.*  We  know,  further,  that  these 
children  cannot  be  taught,  without  special  appliances  and  specially 
trained  teachers,  with  any  degree  of  success.  The  result  of  such 
failure  to  supply  the  proper  means  and  properly  trained  instructors 
is  to  send  them  out  of  the  schools  with  no  real  training  whatever, 
or  with  a  dangerous  superficial  brightness,  and  an  education  that 
will  in  no  way  assist  them  to  live  an  even  partially  successful  life. 

The  situation  in  the  home  is  practically  the  same.  In  a  home 
where  there  is  one  feeble-minded  child  among  a  number  of  children, 
we  have  the  definite  effects  of  such  communication.  To  be  sure, 
we  recognize  the  increase  in  sympathetic  understanding  that  chil- 
dren   and  parents   exercise   toward   such  feeble-minded   children; 

*The  city  of  Houston  has  a  room   for  such   children.     See  p.   21. 


Care  of  the  Feeble~?n,ind0d  and  Insane  in  Texas  45 

but  these  moral  and  social  traits  are  infrequently  developed  and 
far  overbalanced  by  the  amount  of  time  and  energy  required  to 
care  for  such  a  child,  especially  if  he  be  of  the  low  grade  imbecile 
or  idiotic  type.  One  writer  states  that  we  may  figure  without 
error  that  the  time  of  one  adult  is  needed  for  the  care  of  every 
feeble-minded  or  low  grade  imbecile  child  or  adult.  In  a  custo- 
dial institution  five  of  these  defective  children  or  adults  may  be 
cared  for  by  a  single  attendant  in  a  much  better  manner  and  with 
much  better  results  than  in  the  home.  We  are,  then,  by  sending 
such  children  to  institutions  provided  for  their  care,  relieving 
four  out  of  every  five  of  the  normal  adults  now  busied  in  raring 
for  such  defectives,  for  the  economic  and  business  life  of  the 
normal  community. 

Again  we  have  no  satisfactory  data  concerning  the  mere  financial 
cost  of  these  persons  when  they  are  kept  in  the  home  and  allowed 
to  run  in  the  streets.  We  know  practically  nothing  regarding  the 
condition  of  these  people  when  without  proper  care  and  protection. 
There  are  isolated  instances  in  Texas  which  come  to  our  notice 
through  charity  organizations,  and  every  one  of  these  is  such  as 
to  arouse  our  pity  without  ever  suggesting  to  us  a  direct  and  per- 
sonal means  of  aiding  them.  It  is  unquestionably  true  that  eco- 
nomically the  institution  and  custodial  care  for  such  persons  is  in 
the  long  run  far  less  expensive  to  the  State  and  the  people  of  the 
State  than  the  present  individual  and  haphazard  care  that  is  given 
such  dependents. 

The  effect  upon  the  community  at  large  where  one  or  two  or 
more  of  these  defectives  are  living  is  also  difficult  to  estimate.  It 
is  certain  that  the  feeble-minded  girl  and  boy  are  often  the  bearers 
•of  many  of  the  social  diseases,  and  it  is  especially  true  that  feeble- 
minded girls  are,  in  the  large  majority  of  cases,  the  inmates  of 
;our  houses  of  prostitution.  I  quoted  above  a  letter  (page  18) 
from  one  of  these  homes  in  Texas  for  erring  girls  in  which  the 
statement  is  made  that  a  very  large,  percentage  of  girls  brought 
to  this  home  are  of  this  defective  type.  Investigations  of  a  more 
careful  sort  in  other  communities  show  that  this  holds  true  almost 
universally.  In  the  Bedford  Hills  Reformatory,  New  York  City, 
90  per  cent  of  the  girls  there  for  crime  or  misdemeanor  have  never 
attended  a  school  higher  than  the  eighth  grade  of  the  common 


46  Bulletin  of  the  University  of  Texas 

school,  and  a  large  percentage  of  this  group  are  girls  who  would 
not  profit  by  such  school  attendance.  Approximately  60  per  cent 
actually  test  as  defectives,  or  feeble-minded,  in  the  sense  of  the 
definition  given  above.  All  of  these  tilings  indicate  that  the  effect 
upon  the  community  of  the  single  individual  of  this  type  is  bad 
in  the  extreme  in  so  far  as  the  social,  economic,  and  moral  ideals 
of  tbat  community  are  concerned. 

"The  general  public  has  already  been  educated  to  the  belief  that 
it  is  a  good  thing  to  segregate  the  idiot  or  the  distinct  imbecile, 
but  they  have  not,  as  yet,  been  quite  so  fully  convinced  as  to  the 
proper  treatment  of  this  brighter  and  more  dangerous  class,  the 
defective  delinquent.  From  a  financial  standpoint,  segregation  of 
the  defective  delinquent  would  be  a  great  economy,  to  say  nothing 
about  the  more  salient  feature,  that  of  stopping  them  from  produc- 
ing their  kind.  If  we  could  segregate  these  defectives  when  they 
are  young  and  keep  them  confined  during  their  natural  lives,  it 
would  obviate  the  expense  of  having  them  committed  repeatedly 
to  our  penitentiaries  when  they  grow  older.  Under  our  present 
plan  they  are  sent  to  our  penal  institutions  for  a  short  term  after 
committing  some  crime,  allowed  to  go  out  again,  scatter  their 
progeny,  and  commit  other  crimes  and  depredations,  only  to  be 
recommitted  time  after  time.  ...  If  we  take  these  children 
into  our  institution,  brighten  them  up  as  best  we  can,  and  turn 
them  loose  on  the  public,  it  has  not  only  been  a  waste  of  time, 
money,  and  energy,  but  we  have  done  the  world  an  irreparable 
injury.  The  education  and  training  they  receive  in  our  institu- 
tion conceals  their  defects  to  a  certain  extent,  enabling  them  to 
marry  more  easily,  often  into  innocent  families,  and  as  a  result 
we  get  back  several  for  one,  which  is  often  true  if  they  never 
marry. 

"Some  may  say,  'Why  it  is  a  pity  to  confine  these  children  in 
an  institution  all  their  lives';  but  that  is  where  they  are  greatly 
mistaken,  as  for  instance,  in  Ohio,  I  can  say  to  you  that  we  have 
a  community  of  over  1600  of  the  happiest  children  in  the  State 
in  our  institution."* 

*Emerick,  E.  J.,  Supt.  Inst.  Sell,  for  F.  M.,  Columbus,  Ohio,  The  Segre- 
gation of  the  Defective  Classes,  Proc.  N.  E.  A.,   1912,  pp.  1291-2. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  !< 


HISTORY   OF  TREATMENT. 

It  is  an  essential  principle  of  social  solidarity  to  educate  each 
individual  to  the  level  of  his  inherited  capacity.  In  modern  times 
we  recognize  that  the  child  has  a  right  to  that  measure  of  social 
training,  of  education,  and  of  human  enjoyment  and  satisfaction 
which  we  possess.  We  know  today  that  many  poorly  educated 
individuals  may  be  so  merely  because  they  were  poorly  nourished, 
had  bad  eyes  or  hearing,  or  many  other  structural  defects,  in  a 
large  measure  remedial,  that  prevented  them  from  utilizing  the 
opportunities  offered.  Special  care  for  these  in  their  school  days 
was  needed.  Today  greater  and  greater  numbers  of  people  are 
realizing  these  facts,  and  we  are  furnishing  our  pupils  with  med- 
ical supervisors,  trained,  nurses,  and  experts  in  mental  diagnosis. 
The  people  who  advocate  such  advances  argue  that  money  is  wholly 
wasted  in  teaching  a  student  who  cannot  see  by  methods  adapted 
only  for  those  who  can  see.  If  we  spend  but  a  little  more  money 
in  the  right  direction,  then  that  now  being  wasted  will  be  made 
valuable.  The  recognition  of  this  fact  has  led  many  countries  to 
establish  schools  for  backward  children  and  parental  schools,  where 
the  child  difficult  of  control  or  varying  too  widely  from  the  normal 
may  receive  special  oversight.  Today  practically  every  country  of 
importance  also  has  schools  and  institutions  for  the  education  and 
training  of  those  actually  feeble-minded;  too  often  only  education 
imitated,  and  intended  to  make  them  normal. 

To  be  happy  and  attain  in  any  measure  the  development  pos- 
sible, every  feeble-minded  and  backward  child  needs  special  train- 
ing. The  same  amount  of  time  and  trouble  spent  on  two  chil- 
dren, one  bright  and  the  other  feeble-minded,  produces  in  the  first 
knowledge  and  skill — in  the  latter,  greater  mental  confusion  and 
failure.  Yet  a  slight  increase  in  time  and  effort  and  the  appli- 
cation of  special  methods  will  often  brush  away  such  mental  con- 
fusion and  enable  the  child  to  attain  a  certain  measure  of  enjoy- 
ment. 

In  early  times  the  term  idiot  inspired  horror  and  disgust.  Today 
this  is  still  too  often  the  case.  The  Spartan,  striving  to  preserve 
a  healthy  race,  left  these  weaklings  exposed  to  such  dangers  and 
climatic  changes  as  speedily  brought  about  their  death.     In  the 


48 


Bulletin  of  tne  University  of  Texas 


middle  ages  the}^  became  the  fools  or  jesters  in  the  courts,  or  wan- 
dered about  as  wild  men  in  the  woods,  sometimes  classified  as 
belonging  to  the  human  family,  more  often  classified  according  to 
the  animals  among  which  they  were  found,  as  wolves,  sheep,  bears, 


Plate  X. 

This  low-grade  imbecile  is  spending  his  life  at  the 
house.  He  climbs  trees,  going  out  so  far  on  the  small 
break  with  him  and  he  falls  to  the  ground.  All  of 
that  of  a  full-grown  man,  is  expended  in  this  useless 
hundreds  of  others  are  eating  up  the  wealth  of  our 
training,  getting  no  enjoyment  out  of  the  life  that  they 
the  right  to  be  well  born  nor  the  right  to  live  the  best 
lias  been  granted  this  human  being. 


Bexar  county  poor 
branches  that  they 
his  energy,  almost 
fashion.  Literally 
State  and  with  no 
must  live.  Neither 
that  is  in  him  now 


«h"c.     Linnaeus  gives  us  a  list  of  ten  of  these  phenomena,  which 
he  considered  as  forming  a  variety  in  the  genus  homo.* 

Luther  and  Calvin  declared  that  the  idiots  were  persons  filled 
witb    Satan.     At   other   times   and    in    other   places   these   feeble- 


*See   Barr   et    al. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  49 

minded  were  viewed  as  a  visitation  of  God  upon  the  family  into 
which  they  came,  and  at  all  times  they  have  been  enshrouded  in 
mystery.  The  point  of  view  of  the  middle  ages  considered  the 
house  into  which  the  idiot  was  born  as  blessed  of  God,  for,  as  the 
nhrase  had  it,  these  people  "walked  on  earth  and  talked  in  heaven." 

It  was  not  until  1798  that  any  attempt  was  made  to  educate  or 
study  the  feeble-minded  in  any  scientific  manner.  A  party  of 
sportsmen  in  the  woods  of  Caunne  caught  one  of  these  wild  hoys 
and  brought  him  to  Paris.  His  education  was  begun  by  Itard 
and  was  carried  on  for  five  years.  Thus  ended  centuries  of  neglect 
and  ignorance  concerning  these  unfortunates,  and  began  the  period 
of  today,  in  which  we  are  gradually  spreading  the  knowledge  con- 
cerning the  origin  and  proper  care  of  mentally  enfeebled  human 
beings. 

As  early  as  the  sixteenth  century  the  Cretins  in  the  canton  of 
Wallis  in  Switzerland  had  attracted  notice.  They  were  described 
as  having  "misshapen  bodies,  deformed  heads,  swollen  tongues, 
almost  entirely  without  power  of  speech,  staring  on  the  ground, 
with  darkened  countenance,  the  object  of  curiosity  and  scorn."  In 
1811  Napoleon  ordered  a  census  to  be  taken  of  these  people.  It 
was  found  that  there  were  some  3000  in  the  canton.  The  plan  he 
had  in  mind  contemplated  moving  the  Cretin  to  a  better  and 
healthier  climate  with  a  view  to  effecting  a  cure,  or  at  least  pre- 
venting an  increase  of  the  population.  This  failed  because  of  its 
very  magnitude.  In  1836,  however,  a  poor,  deformed  Cretin,  mur- 
muring his  prayers  before  a  wayside  cross,  attracted  the  attention 
of  Guggenbiihl,  a  young  physician  of  the  canton  Zurich.  For  two 
years  he  lived  among  the  Cretins  and  studied  their  condition. 
Then,  convinced  that  he  could  bring  relief  to  many  of  them,  he 
published  a  paper  on  Cretinism  in  Switzerland,  and  appealed  to 
the  government  for  assistance.  A  plantation  four  thousand  feet 
above  sea  level  was  placed  at  his  disposal.  The  methods  pursued 
in  this  colony  were  very  simple.  A  regular  diet  was  prescribed, 
and  the  senses  were  continually  called  into  action  by  exaggerated 
and  oft-repeated  stimuli.  Attempts  were  made  continually  to  fix 
the  wandering  attention  of  the  feeble-minded.  The  colony  ran 
successfully  for  twenty  years.  Then,  through  envying  suspicion 
and  enemies  caused  by  the  success  of  the  institution,  political  diffi- 


50  Bulletin  of  the   University  of  Texas 

culties  arose  which  forced  Guggenbuhl  to  retire.  His  institution 
was  dissolved  and  the  final  outcome  of  such  a  work  was  left  in 
doubt. 

In  1837  Seguin,  who  was  a  pupil  of  Itard,  opened  a  private 
school  in  Paris  with  the  avowed  intention  of  educating  the  idiot. 
His  work  was  so  successful  that  Dr.  Ferrus,  president  of  the 
Academy  of  Medicine  and  Inspector  General  of  the  Lunatic  Asy- 
lums of  France,  had  him  appointed  to  the  directorship  oi  the 
School  for  Idiots  at  Bicetre.  As  a  result  of  his  work  in  this 
famous  hospital,  he  published  two  pamphlets  that  won  praise  from 
the  famous  hospital  and  later  the  endorsement  of  the  French  Acad- 
emy of  Sciences.  We  may  summarize  the  results  of  his  experiment 
as  follows : 

"The  necessary  conditions  for  the  improvement  of  imbeciles  are 
that  the  treatment  not  only  be  hygienic,  but  moral;  that  the  edu- 
cation he  not  the  putting  in  action  of  acquired  faculties,  which  is 
the  education  of  the  common  schools,  but  the  development  of  the 
functions  of  the  aptitudes  of  the  faculties  and  of  the  instinctive 
and  moral  tendencies.  These  are  to  be  first  ascertained  by  careful 
physiological  and  psychological  examination  or  analysis  of  each 
case,  and  the  program  of  education  is  as  follows: 

1.  The  moving  power. 

2.  The  senses. 

3.  Perceptive  faculties. 

4.  By  gymnastics  of  comparison. 

5.  By  gymnastics  of  invention. 

6.  Excitement  of  sentiments  and  instincts  by  normal  neces- 
sities. 

7      Special  excitation  of  the  faculty  of  spontaneousness. 

8.  Incessant  provocation  to  regulate  action  to  speaking  and  to 
the  exercise  of  faculties  then  developed. 

The  aptitudes  thus  created  are  then  applied  to  different  special- 
ties according  to  the  fortune,  age,  or  condition  of  each  individual,, 
taking  care  to  choose  in  every  case  an  occupation  which  will  keep 
in  activity  the  muscular  system  as  well  as  the  mental  faculties." 

It  will  be  impossible  in  a  short  paper  to  discuss  in  detail  the 
history  of  the  development  of  the  training  and  education  of  the 

*Barr,   Mental  Defectives,  p.   34. 


('(ire,  of  the  Feeble-minded  and  Insane  in  Texas 


5) 


feeble-minded  in  the  different  countries.  Along  in  the  middle  of 
the  nineteenth  century  the  beginning  of  such  study  and  attempts 
at  education  were  made  in  a  large  number  of  countries,  notably 
France,  England,  and  America.  Previous  to  this  time  the  care  of 
the  feeble-minded  had  been  left  to  the  church  very  largely.  We 
find  in  history  scattered  instances  of  retreats  started  by  the  nuns 
and  monks  for  the  care  and  piotection  of  these  individuals,  but 
until  the  work  of  Itard  in  France  and  that  of  Seguin,  his  pupil, 
in  France  and  America,  no  definite  plan  of  education  had  been 
established. 


Plate  XI. 

Exhibit  of  work  done  by  the  pupils  in  the  Special  Room  of  the  Rusk  School, 
Houston,  Texas. 


At  the  same  time  that  this  work  was  going  on  in  France,  Dr. 
Samuel  G.  Howe,  director  of  the  Perkins  Institute  for  the  Blind 
at  Boston,  became  interested  in  those  of  unsound  mind.  In  1S39, 
he  writes,  a  child  was  received  at  his  institution  not  only  blind, 
but  unsound  in  mind  and  paralyzed.  Under  a  course  of  treatment 
persisted  in  according  to  physiological  and  hygienic  laws,  its  con- 
dition was  so  far  ameliorated  as  to  encourage  him  in  taking  two 
similar  cases.     He  infers :     "If  so  much  could  be  done  for  idiots 


52 


Bulletin  of  the  University  of  Texas 


who  were  blind,  still  more  could  be  accomplished  for  those  who 
have  their  sight." 

In  1846  interest  in  his  work  reached  such  a  point  that  the 
commonwealth  of  Massachusetts  appointed  a  committee  to  inquire 
into  the  condition  of  idiots  in  that  commonwealth.  The  report  of 
this  commission  gave  a  full  statement  of  the  condition  and  treat- 
ment of  idiots  in  almshouses  and  private  families.  It  contrasted 
with   this  treatment  what   was  being  done  for  mental   defectives 


Plate  XII. 

Three  imbeciles  at  the  Grayson  county,  Texas,  poor  farm.  These  three  sat 
together  for  forty  seconds  during  the  exposure  of  the  plate.  The  middle  one 
moved  slightly.  Three-quarters  of  an  hour  later  they  were  still  sitting  in  this 
position  on  the  bed.  This  is  their  entire  occupation  day  after  day.  Each  one 
is  capable  of  training  and  could  be  taught  to  do  many  simple  tasks 

in  the  training  schools  of  Switzerland,  Germany,  and  France.  As 
a  result  of  this  report,  the  State  appropriated  $2500  annually  for 
a  term  of  three  years  for  the  establishment  of  an  experimental 
school.  This  school  was  opened  in  1848,  and  was  continued  in 
connection  with  the  Perkins  Institute  for  the  Blind.  At  the  end 
of  1850,  the  success  of  the  experiment  had  been  so  thoroughly 
proved  that  the  Massachusetts  Assembly  incorporated  the  Massa- 
chusetts School  for  Idiotic  and  Feeble-minded  Children.     In  look- 


Care  of  the  Feeble-mindvd  a/nd  Insane  in  Texas 


13 


ing  about  for  a  person  to  assist  him  in  the  difficult  task  of  direct- 
ing the  two  institutions,  Dr.  Howe,  through  correspondence  with 
Dr.  Seguin  in  Paris,  finally  persuaded  him  to  come  to  this  country. 
"Thus  it  happened  that  the  first  effort  to  introduce  foreign  methods 
of  training  mental  defectives  into  America  was  recognized  and 
implanted  by  one  himself  largely  the  author  of  these  methods."' 
Dr.  Seguin  remained  in  America  a  number  of  years,  working  in 
Massachusetts,  New  York,  and  New  Jersey.  There  still  remained 
a  short  time  ago  at  Orange,  Xew  Jersey,  a  private  school  for 
feeble-minded  pupils,  maintained  by  his  widow. 

New  York  appointed  a  commission  on  idiocy  in  1846.  In  1851, 
through  the  interest  aroused  by  the  work  in  Massachusetts,  an 
experimental  school  was  opened  in  Albany.  The  possibilities  of 
such  a  school  were  successfully  demonstrated,  and  permanent  quar- 
ters for  the  school  were  selected  at  Syracuse.  Here  was  erected 
the  first  building  in  America  for  the  specific  purpose  of  caring  for 
the  feeble-minded.  In  1852,  James  B.  Eichards,  the  first  teacher 
selected  by  Dr.  Howe  as  a  regular  teacher  of  the  feeble-minded  in 
the  Massachusetts  school,  came  from  his  work  in  Boston  and  opened 
a  private  school  in  Germantown,  Pennsylvania.  As  a  result  of  his 
work  a  corporation  was  formed  in  1853,  and  a  board  of  directors 
was  appointed  to  undertake  the  responsibility  of  the  school,  retain- 
ing Mr.  Eichards  as  their  teacher.  An  exhibit  of  the  work  done 
in  this  school  resulted  in  obtaining  an  appropriation  from  the  State 
of  $10,000  during  the  winter  of  1854.    ■ 

It  would  be  of  interest  to  follow  in  detail  the  work  of  these 
three  States  in  developing  the  State  care  and  treatment  of  the 
feeble-minded.  We  know  now,  however,  the  success  that  such 
work  has  won  in  the  above  States.  In  New  York  there  are  five 
institutions  given  over  to  the  training  and  care  of  the  idiot  and 
feeble-minded.  Pennsylvania  has  three.  In  Pennsylvania,  for 
example,  in  1906  there  was  an  estimated  population  of  15,000 
feeble-minded  in  the  State.  Twenty-five  hundred  of  these  were 
cared  for  during  that  year  in  State  institutions.  The  success  of 
this  method  of  care  is  attested  in  that  State  by  the  fact  that  at 
that  time  there  were  2241  applications  for  new  admissions  on  file. 
In  New  York  within  the  last  few  years  a  colony  has  been  pro- 
jected that  will,  it  is  hoped,  care  for  the  greater  majority  of  the 


54  Bulletin  of  the  University  of  Texas 

feeble-minded  population  of  that  State.  As  a  matter  of  fact,  the 
need  for,  and  the  success  of  these  schools  point  out  to  us  that  the 
problem,  by  means  of  segregation  and  prevention,  would  solve  itself 
in  time  if  we  but  seriously  undertook  to  provide  means  for  segre- 
gation in  the  form  of  ample  institutional  space.  In  the  following 
section  Ave  wish  to  examine  more  closely  the  types  of  care  now 
provided  in  many  of  the  States. 

SEGREGATION  AND  STATE  CARE. 

"The  adoption  of  the  colony  for  both  the  feeble-minded  and 
epileptic  with  its  settlements  placed  about  on  a  large  acreage  of 
land,  promises  to  furnish  the  largest  measure  of  relief.  The  parent 
institution  would  receive  all  patients,  train,  instruct,  and  discipline 
as  deemed  advisable  and  necessary  for  future  usefulness,  and  when 
the  school  department  can  do  no  more  for  them,  they  should  be 
turned  over  to  the  colony,  together  with  all  patients  received  who 
are  too  old  for  the  school,  retaining  them  long  enough  to  train  and 
classify.  The  colony  consisting  of  not  less  than  2000  acres  of 
land  should  be  located  where  State  property  could  be  acquired,  or 
on  cheap,  rough  land  upon  which  the  labor  of  the  colonists  could 
be  used  to  clear,  cultivate  and  plant,  building  their  own  homes 
and  developing  such  industries  as  are  best  suited  to  their  abilities. 
Here  the  able-bodied,  feeble-minded,  and  epileptic  could  find  a 
permanent  home,  where  their  lives  could  be  spent  in  useful  labor 
and  quiet  happiness,  receiving  such  care  and  supervision  as  deemed 
necessar}-."* 

Many  tests  and  special  examinations  are  being  made  in  reform- 
atories and  among  people  of  these  classes  to  determine  the  actual 
conditions  demanding  such  treatment.  More  must  be  made  before 
the  whole  story  can  be  told.  In  this  respect  the  investigation  of  a 
single  case  may  tell  volumes.  For  example,  we  may  quote  as  one 
illustration  out  of  many  the  examination  made  of  fifty-six  girls 
who  had  been  inmates  of  the  Massachusetts  reformatory,  but  had 
been  released  on  probation. 

*Ninth  Biennial  Report  of  Michigan  Home  for  Feeble-minded  and  Epi- 
leptic, Lapeer,  Michigan,  June  30,  1912,  p.  11.  (The  home  institution  in 
Michigan  is  on  the  cottage  plan  largely,  but  the  managers  still  feel  the 
need  of  the   colony   system.) 


Care  of  the  Feeble-mindad  and  Insane  in  Texas  55 

"We  [New  Jersey  Training  Sehool]  examined  fifty-six  girls 
who  had  been  inmates  of  the  Massachusetts  reformatory,  but  had 
been  released  on  probation.  They  were  selected  because  of  their 
bad  conduct  and  inability  to  remain  in  the  homes  found  for  them. 
Fifty-two  of  the  fifty-six  were  distinctly  feeble-minded.  Note  their 
type  as  shown  in  the  following  two  cases: 

No.  1  is  eighteen  years  old  and  tests  twelve.  Father  is  drinking 
man;  mother,  a  low-grade  woman,  absolutely  no  sense  or  power 
to  control  her  children,  probably  immoral.  One  brother  out  of 
reformatory  on  probation;  another  just  out  of  truant  school  on 
probation.  Girl's  history :  hard  to  manage ;  was  a  fairly  good 
scholar,  a  great  mischief-maker,  and  a  terrible  story-teller.  Would 
call  up  strange  people  on  telephone.  Took  a  much  prized  hand- 
woven  towTel  belonging  to  the  lady  for  whom  she  worked,  and  cut 
it  up  to  make  a  dressing  sacque.  Will  do  work  well  one  day  and 
the  next  not  seem  able  to  do  anything.  Will  steal  little  things. 
So  untruthful  and  such  a  trouble  maker;  tells  stories  about  the 
people  for  whom  she  works,  and  is  so  crazy  about  the  men  (has 
been  immoral)  that  she  cannot  keep  a  position. 

No.  2  is  twenty  years  old;  tests  nine.  (Indian  blood.)  Mother 
immoral — living  with  a  man  not  her  husband — keeping  house  of 
ill-fame,  using  her  children  for  gain.  Own  father  alcoholic — lives 
with  a  woman  not  his  wife — attempted  rape  on  his  own  children. 
Two  sisters  immoral — one  (been  in  prison)  now  living  a  vicious 
life.  A  younger  sister  insane.  A  younger  brother  an  unruly  boy. 
Girl's  history :  Committed  at  fifteen  as  beyond  control,  immoral, 
and  a  runaway.  Eesponded  to  little  training.  Never  worked  with- 
out supervision.  Fond  of  attracting  attention.  Would  faint  on 
street  or  in  store  to  create  scene.  Paid  $10  for  doll.  Did  not  care 
to  play  with  it,  only  that  it  was  pretty.  Had  child,  father  un- 
known. Wholly  incompetent  to'  care  for  it.  Some  days  wants  to 
give  baby  away  and  the  next  day  would  not  part  with  it  for  the 
world.     Very  nervous  and  moody. 

Of  one  hundred  youths  in  the  detention  home  of  the  Newark 
Juvenile  Court  we  found  one  who  had  average  normal  mentality. 
All  the  rest  were  below,  while  sixty-six  of  them  were  so  far  below 


56 


Bulletin  of  the  University  of  Texas 


as  to  be  beyond  question  feeble-minded."*  A  large  percentage  of 
paupers,  drunkards,  of  those  convicted  of  petty  thieving,  are  feeble- 
minded, or  quite  incapable  of  maintaining  themselves  against  the 
temptations  of  their  environment.  These  must  also  be  removed 
and  protected. 


Plate  XIII. 
"A  Child  Who  Has  Helped  to  Lead  the  Way." 

"In  the  movement  for  more  adequate  provision  for  the  feeble- 
minded, a  place  beside  the  scientists  and  physicians  and  educators 
and  legislators  must  be  made  for  this  little  half-witted  girl.  The 
facts  of  her  heredity  were  published  in  the  first  annual  report  of 
Letchworth  Village.     They  have  done  more  than  heavy  tomes  to 

*Go'ddard,  H.  H.,  The  Basis  for  State  Policy,  The  Survey,  v.  27,  1911- 
1912,  p.    1852. 


Care  of  the  Feeble-mind&d  and  Insane  in  Texas 


51 


convince  people  that  it  is  had  policy  to  let  the  feeble-minded  drift 
in  and  out  of  the  almshouses;  that  it  is  hut  humanity  and  economy 
to  segregate  them  and  to  strike  at  the  causes  of  mental  defect. 

"Emma  W.  came  to  life  in  an  almshouse,  stamped  with  illegiti- 
macy and  feeble-mindedness.  Her  family's  record  reads:  Mother, 
two  brothers  and  a  sister  feeble-minded  ;  mother's  father  feeble- 
minded and  mother's  mother  tuberculosis.  When  a  second  child 
was  expected  the  mother  was  induced  by  well-meaning  people  to 


-HEREDITY  CHART 

OF 

EMMA  W. 

BORN  FEBRUARY  II™   1889. 


GfrifiOMTHfff  GrRHOMOTMC* 


MOTHER  (JH< 


Uhcl  e  a On  t  Uhcl  e 

•  •• 


c/f?st  Child     SecohoChilo    TmrrbCHuo     foc/ithChilo   F/ftmChilo      S/xrxCt//ic 


o     StrfwCH/ut:  £~/G/frtfO//L0. 


EMMA  MENTf)t_  MENTHL  MCMTHL  MCNT/jL  AfE/VT/IL  MENTfIL  MENTAL, 

Hl<.H  GRHDF.     DfFCCTIfE  DEFECr/fe        DEFECTIVE  OEFCCTIfe        OCFECT/VF         DEFECT/fE     OEFECT/rE 

IMBECILE 

Plate  XIV. 

marry  the  father,  who  was  a  drunken  epileptic.  Two  children 
were  born.  Still  later  the  same  well  meaning  people  aided  her  to 
get  a  divorce  to  marry  the  father  of  another  child  about  to  be  born. 
Since  then  four  more  have  been  born.  All  of  these  children  are 
feeble-minded.  Entire  family,  with  exception  of  oldest  child,  is 
at  large."* 

From  the  chart  above  Emma  W.  may  be  seen  to  be  the  oldest 
daughter  of  a  mother  who  bore  eight  feeble-minded  children. 

Concerted  action  by  State,  city,  and  county  can  alone  reach  the 


*The  Survey,  v.  27.   1011-1012,  p.   1837. 


58  Bulletin  of  the  University  of  Texas 

solution  of  such  problems  as  these.  No  individual  charity,  be  it 
church  or  charity  organization,  can,  unaided,  stop  the  ever-increas- 
ing mass  of  degraded  humanity  that  reproduces  itself  more  rapidly 
than  the  other  types  of  society. 

It  is  obvious  from  our  study  of  the  causes  of  feeble-mindedness 
and  the  conditions  in  which  these  defectives  live  and  propagate 
their  kind  that  the  problem  has  become,  under  modern  social  de- 
velopments, almost  entirely  an  administrative  and  executive  one. 
Defectiveness  of  all  types  cannot  be  cured,  hence  the  physician  and 
public  health  agencies  are  helpless  in  the  premises.  Charity  can 
only  relieve  the  immediate  hunger  or  offer  clothing  for  momentary 
needs.  Its  work  rs  always  to  be  repeated.  Permanent  relief  is 
impossible  among  the  shiftless  and  improvident  who  are  so  because 
of  mental  or  moral  defect.  The  only  relief  worthy  of  the  name  is 
permanent  oversight  and  care.  For  the  totally  helpless,  this  must 
be  in  institutions,  villages,  and  farm  colonies.  In  another  place 
we  have  described  the  t}^pe  of  institution  and  village  that  are  most 
sirited  to  the  support  and  care  of  the  feeble-minded.  These  insti- 
tutions and  villages  enable  us  to  segregate  those  of  child-bearing 
age  and  to  care  for  the  idiot  and  low-grade  imbecile.  Connected 
with  the  institution,  it  is  undoubtedly  the  best  arrangement  to 
have  a  large  farm. 

A  combination,  in  other  words,  of  the  institution  and  the  farm 
is  probably  the  ideal  situation  and  arrangement  at  the  present  time. 
This  would  necessitate  the  classification  of  our  defectives  on  the 
basis  of  need  for  care  and  possibilities  of  self-support.  A  great 
many  of  the  higher  class  of  defectives  may  be  used  in  such  an 
institution  to  care  for  the  more  helpless.  It  has  been  found  that 
the  sympathy  and  interest  in  others  acquired  by  these  defective 
persons  as  they  care  for  their  less  favored  fellow-beings  aids  greatly 
in  maintaining  discipline  and  keeping  them  happy.  Besides  this 
it  relieves  the  State  and  the  institution  of  a  great  deal  of  expense 
in  providing  outside  attendants. 

Those  of  child  bearing  age,  if  kept  separate  from  the  lower  class, 
are  usually  kept  in  villages  and  farm  colonies.  The  location 
of  such  a  village  or  cluster  of  houses  may  be  on  the  farm  itself. 
Or,  as  in  Massachusetts,  a  more  expensive  arrangement,  the  farm 
mav  be  many  miles  awav  from  the  institution  and  those  who  are 


Care  of  the  Feeble-minded  and  Insane  in  Texas  59 

capable  of  working  on  it,  especially  the  men,  may  be  sent  there 
and  kept  throughout  their  life.  The  cost  of  maintaining  these 
colonies  is  naturally  more  expensive  in  the  beginning  than  it  is 
as  the  farm  becomes  more  and  more  productive.  In  one  colony 
during  the  first  six  months  of  its  existence  the  feeble-minded  on 
the  farm  paid  all  but  $70  apiece  of  their  support.  The  $70  was 
the  total  cost  to  the  State  per  individual  for  the  year.  Such  an 
arrangement  also  gives  them  the  proper  exercise  arid  training. 
The  colony  in  Massachusetts  and  the  colony  in  Maine  both  report 
that  the  health  of  the  young  men  and  women  on  these  farms  was 
very  much  better  than  it  had  ever  been  in  the  institution  itself. 
In  such  States  as  these  the  weather  is  extremely  cold  with  long 
winters,  and  we  might  easily  expect  the  conditions  to  be  more 
difficult  of  control.  The  result  has  been  very  satisfying  indeed 
if  it  succeeds  even  partly  as  they  have  described.  In  a  State  like 
Texas  we  could  hope  for  even  better  results  where  the  climate  is 
far  less  rigorous  than  in  the  North. 

There  will  be  still  a  third  class  of  high-grade  morons  and  de- 
fectives who,  after  a  number  of  years  of  training  in  the  institution 
school,  may  be  sent  out  into  the  ordinary  channels  of  business. 
It  will  be  necessary,  however,  to  keep  continuous  watch  over  such 
persons.  We  can  never  hope  to  train  them  so  successfully  that 
their  defects  will  not  partially  incapacitate  them  and  endanger 
their  position  m  life.  The  method  of  control  of  these  probably 
will  have  to  be  through  the  parole  system.  It  will  be  necessary 
to  have  them  report  at  stated  intervals  to  the  institution  or  to 
some  probation  officer  and  these  reports  kept  on  file  in  the  institu- 
tion. The  social  visitor  connected  with  the  institution  will  make 
this  parole  system  a  part  of  his  or  her  business,  and  at  times  visit 
these  wards  of  the  State. 

Homes'  must  be  selected  on  the  basis  of  sympathetic  understand- 
ing and  a  clear  and  definite  notion  on  the  part  of  the  persons  in 
the  home  must  exist  concerning  the  status  of  the  defective.  There 
are  many  homes  in  which  such  a  person  could  not  work  at  all,  and 
many  others  in  which  his  life  would  be  not  only  a  burden  to  him 
but  probably  disruptive  of  the  home  itself.  All  of  these  problems 
are  problems  for  the  institution  and  the  central  agencies  to  inves- 
tigate  and  solve. 


60  Bulletin  of  the  University  of  Texas 


MODERN  INSTITUTIONS  AND  COLONIES. 

April  21,  1914. 

"Dear  Sir:  I  saw  an  article  in  the  Statesman  some  time  since 
about  the  several  institutions  in  Austin  for  the  good  and  uplift 
of  the  people.  Among  other  institutions  was  the  Maxwell  institu- 
tion for  Aveak-minded  children.  The  article  gave  great  praise  to 
the  founders  of  this  institution,  and  I  would  like  to  say  a  few  words 
concerning  it.  This  institution  is  probably  doing  a  good  work 
for  those  who  are  able  to  pay  for  it,  but  their  charges  are  entirely 
beyond  the  reach  of  the  laboring  people. 

"I  have  a  boy  now  eleven  years  of  age,  who  has  been  of  weak 
mind  from  birth.  My  wife  went  to  see  the  people  managing  this 
institution  over  a  year  ago,  hoping  to  be  able  to  get  our  little  boy 
into  this  institution  for  treatment.  Under  no  conditions  would 
they  have  anything  to  do  with  him  unless  we  were  able  to  pay  the 
sum  of  $50  per  month.  I  am  a  telegraph  operator,  and  my  salary 
is  about  $75  per  month.  Naturally  we  could  not  possibly  live  and 
pay  such  a  charge.  It  is  very  evident  that  this  institution  was 
not  founded  for  the  help  of  the  people,  or  for  poor  unfortunates, 
but  was  established  to  make  money  out  of  the  unfortunate  parents 
of  imbecile  children.  It  is  utterly  impossible  for  any  but  the 
rich  to  avail  themselves  of  the  benefits  this  institution  is  able 
to  give. 

"In  regard  to  my  own  case,  I  do  not  want  the  State  of  Texas 
to  take  care  of  my  boy.  I  am  perfectly  willing  to  do  that  myself, 
just  as  long  as  I  can;  but  it  does  seem  to  me  that  this  great  State 
should  provide  some  place  where  such  children  can  be  taken  care 
of  and  instructed  in  the  proper  way.  The  State  could  charge 
whatever  the  actual  cost  of  instruction  and  care  might  be ;  an 
amount  that  would  be  less  than  half  the  charge  made  by  this 
institution.  This  would  bring  such  an  institution  within  the  reach 
of  the  laboring  people.  ...  I  know  that  the  establishment 
of  such  an  institution  that  would  benefit  my  poor  unfortunate  boy 
has  been  talked  of  a  great  deal,  and  I  think  such  a  bill  was  intro- 
duced in  the  Legislature,  but  nothing  came  of  it.  I  am  in  a 
position  to  do  nothing,  but  it  seems  to  me  that  you  as  the  head 


Care  of  the  Feeble-minded  ami  Insane  in  Texas  Gl 

of  this  good  society  (State  Conference  of  Charities  and  Correc- 
tions) might  take  the  matter  up  and  push  it  till  there  was  some- 
thing done.     .     .     . 

"Now,  Mr.  Potts,  I  have  explained  my  case  to  you  just  as  it  is, 
and  there  are  no  doubt  thousands  of  similar  cases  in  this  great 
State.  It  seems  to  me  that  the  State  could  rent  a  building  for 
this  purpose  until  such  time  as  it  would  require  to  erect  a  per- 
manent building.  The  State  could  operate  the  institution  at  actual 
cost.  T  would  be  glad  to  pay  from  $15  to  $25  monthly  to  have 
my  boy  in  such  a  place.  I  could  pay  this  amount  and  still  live; 
1  could  not  possibly  pay  $50  per  month.     .     .     ."* 

Education. — The  situation  described  in  this  letter  and  existing 
in  many  other  homes  in  Texas  expresses  more  clearly  than  long 
argument  the  appeal  for  education  and  training  made  by  the 
friends,  relatives,  and  parents  of  feeble-minded  children.  We  and 
their  neighbors  know  their  children  cannot  attend  school ;  we 
know  that  they  are  not  like  other  children,  but  that  is  all  we  know. 
I  quoted  above  (page  20)  a  letter  of  a  woman  who  ignorantly 
wanted  to  place  her  child  in  an  asylum  for  the  insane.  Many 
write  us  asking  as  this  man  did,  "Do  you  know  of  a  school  where 
I  could  send  my  child?"  In  the  city  of  Austin  the  writer  knows 
personally  of  families  who  would  gladly  send  their  children  to  such 
schools  and  pajr  the  actual  cost  of  schooling  if  the  school  existed. 

Once  the  State  supplies  the  school  and  proper  institutional  sur- 
roundings, two  questions  arise:  How  can  we  tell  the  mental  de- 
velopment of  any  individual  child?  and  What  educational  means 
are  best  suited  to  bring  out  all  that  the  child  is  capable  of?  Dr. 
Barr  gave  us  a  classification  that  is  based  on  the  "try  and  see" 
method.  It  is  easily  seen  that  such  a  method  wastes  much  time 
and  energy.  The  inexpert  recognize  the  profound  idiot,  but  many 
mistakes  must  necessarily  result  from  any  haphazard  procedure. 
In  recent  years,  two  or  three  methods  of  testing  mental  develop- 
ment have  been  proposed.  The  De  Sanctis'  tests  are  six  in  number 
and  very  simple.  The  Binet  and  Simon  tests  were  published  in 
1908. f     By  means  of  this  scale  we  are  readily  able  to  determine 

*Extract    from    letter    received    by    Prof.    C.    S.    Potts,    Chairman    State 
Conference  of  Charities  and  Corrections,  April  22,   1914. 
tSee  translation  by  Clara  Harrison  Towne. 


62  Bulletin  of  the  University  of  Texas 

with  considerable  accuracy  the  standard  of  intelligence  of  the  child. 
We  cannot  quote  these  tests  in  full  here,  nor  even  give  an  adequate 
summary  of  them.  We  may  illustrate  the  entire  series,  however, 
by  quoting  the  tests  for  a  child  whose  mental  age  is  four. 

1.  Sex  of  child.     Are  you  a  little  boy  or  a  little  girl? 

If  testing  a  girl,  give  the  question  in  this  form:  Are  you  a 
girl  or  a  boy  ? 

Children  of  three  do  not  know.     Children  of  four  always  do. 

2.  Naming  familiar  objects.  One  takes  from  his  pocket  a  key, 
a  knife,  and  a  penny. 

The  answers  should  indicate  that  the  child  knows  what  each  is. 
This  is  a  more  difficult  use  of  language  than  naming  objects  in 
the  picture  (test  for  child  of  three)  because  then  the  child  chose 
his  own  object  to  name;  here  we  say,  "what  is  that  thing?" 

3.  Eepetition  of  three  figures :    "7,  2,  9." 

Pronounce  the  figures  distinctly  one-half  second  apart  and  with- 
out emphasis  on  any  one  figure. 

4.  Composition  of  two  lines. 

Draw  two  parallel  lines  3  cm.  apart,  the  one  5  cm.  and  the 
other  6  cm.     Hesitation  is  failure. 

The  technique  of  the  test  is  simple,  but  it  takes  the  trained 
psychologist  who  has  had  actual  practice  to  get  completely  satis- 
factory results.* 

In  the  second  place,  now  that  we  know  the  mental  age  of  the 
child,  how  is  he  to  be  trained?  The  steps  of  the  process  begin 
where  the  deficiency'  is  noticed  in  the  lowest  round  of  growth. 
Seguin  says:  "Let  it  be  one  of  our  first  duties  to  correct  the 
automatic  motions,  and  supply  the  deficiencies  of  the  muscular 
apparatus;  otherwise  how  could  we  expect  to  ripen  a  crop  of  intel- 
lectual faculties  on  a  field  obstructed  by  disordered  functions  ?"f 
The  second  important  step  associates  useful  activities  with  these 
adjustments  as  they  are  learned.  There  must  be  no  slip  in  the 
process,  absolute  repetition  is  essential  to  make  the  new  element 
a  part  of  the  old.  In  the  third  place,  these  people  will  probably 
never  be  able  to  do  any  high  degree  of  abstract  thinking.  Their 
work  and  play  as  we  come  to  the  higher  grades  will  be  best  done 

*Goddard   in   White   and   Jelliffe,   op.   cit.,   art.    on   Feeble-mindedness. 
tSeguin,  Ed.,   Idiocy:    and  Its   Treatment,  Albany,   N.   Y. 


Care  of  the  Feeble-minded  and  Insane  in  Texas 


63 


in  the  manual  arts,  music,  outdoor  occupations,  as  farming,  brick- 
making,  tending  live  stock,  and  numerous  similar  activities,  where 
under  direction  many  reach  the  normal  man's  output  of  finished 
labor.  The  concrete  end  must  be  directly  presented.  Skill  in 
leading,  writing,  and  numbers  demands  abstract  thinking,  all  three 
of  these  processes  to  have  significance  are  symbolic  and  mere  signs 
for  concrete  processes.  It  is  futile  to  attempt  any  great  progress 
in  these  lines  with  any  but  the  higher  grades.  The  emphasis  of 
all  training  must  rest  on  efforts  that  lead  them  toward  self-sufficient 


Plate  XV. 

Feeble-minded  boys  at  work  in  tbe  manual  training  department  of  the  Penn- 
sylvania Training  School  at  Elwyn,  Pa.  Fiftieth  Annual  Report  of  the  School, 
opposite  p.  22. 


habits  of  conduct  and  to  do  things  that  aid  in  earning  them  a 
livelihood  or  lead  to  an  increased  pleasure  in  living. 

The  general  type  of  work  and  detailed  apparatus  and  methods 
of  school  training  is  concretely  described  in  the  reports  and  pros- 
pectuses of  the  schools  already  established  in  many  States.  Prob- 
ably the  best  known  of  the  semi-private  institutions  is  located  at 
Vineland,  "New  Jersey.  We  quote  from  the  1912  report  of  the 
first  school  that  had  a  building  of  its  own  built  out  of  State  funds: 


Care  of  the  Feeble-minded  and  Insane  in  Texas  65 

"The  aim  of  the  school  is  to  develop  each  child  to  the  limit  of  In- 
capacity by  constant  occupation  from  morning  until  night  in 
school  classes,  industrial  and  manual  tasks,  physical  exercise,  and 
play,  changing  often  to  stimulate  an  unflagging  interesl  and  pleas- 
ure in  each.  Emphasis  is  laid  upon  training  in  useful  occupa- 
tions so  that  when  the  child  grows  older  he  may  contribute  to 
Ids  support."* 

In  the  sixty-third  annual  report  of  the  same  institution  (1913, 
page  7),  the  managers  describe  their  relations  to  the  parents  and 
friends  of  their  children  thus: 

"The  resident  officers  have  made  special  efforts  to  promote  cor- 
dial feeling  between  the  institution  and  its  visitors.  Parents  who 
have  brought  their  children,  filled  with  grief  and  misgivings  at 
the  separation,  have  seen  the  boys  and  girls  at  work,  in  school 
and  at  play,  have  departed  feeling  that  it  was  a  special  privilege 
to  have  the  advantage  of  such  a  training  school.  In  spite  of  any 
law  that  may  be  passed,  permanent  segregation  of  the  feeble- 
minded will  never  be  possible  until  the  friends  of  the  children  are 
shown  that  the  modern  institution,  with  its  friendly  officers  and 
employees,  its  school  music,  dancing,  games,  and  moving  pictures, 
is  the  best  place  for  their  children.  The  feeble-minded  child  out- 
side the  institution  is  teased  and  abused  by  his  associates  and  mis- 
understood by  his  superiors;  inside,  he  lives  a  busy,  happy  life 
among  his  equals.*' 

The  previous  discussion  illustrates  the  possibilities  in  the  edu- 
cation of  the  feeble-minded.  After  the  application  of  the  Binet 
tests  we  know  almost  certainly  if  the  child  has  tested  a  particular 
mental  age  that  he  is  partially  educable  to  that  age,  and  that  he 
will  never  go  beyond  that  age  in  any  appreciable  degree.  Special 
methods  can  do  no  more  than  educate  the  slight  mentality  present; 
it  cannot  produce  capacity.  Schools  for  the  feeble-minded  are 
not  to  make  them  trained  and  educated  persons  in  the  usual  sense 
of  that  term ;  their  purpose  must  be  merely  to  develop  and  train 
to  the  point  of  mental  arrest. 

The  probability  that  any  advance  beyond  this  is  slight,  indeed, 
though   the  ideas  advanced   by  Seguin  are  still  to  be  seen  in  the 

*  Sixty-second  Annual  Report  of  the  Managers  of  the  Syracuse  State  In- 
stitution for  Feeble-minded  Children,  Albany,  N.  Y.,  Part  I,  p.  23. 


66  Bulletin  of  the  University  of  Texas 

laws  enacted  by  legislatures  and  in  a  few  schools  for  the  training 
of  mental  defectives.  The  Illinois  application  blank  indicates  those 
may  be  received  "who  may  be  benefited  by  the  instruction." 
"Delaware  orders  its  patients  discharged  when  they  may  no 
longer  receive  benefit  from  training."  "To  discharge,  unsteril- 
ized,  the  defective  child,,  after  having  taught  him  habits  of  neat- 
ness and  a  few  tricks  that  make  his  mental  deficiency  less  notice- 
able, is  worse  than  never  to  have  put  him  in  an  institution."* 
Tn  other  words,  the  defective  is  a  person  who,  for  the  good  of 
society,  must  end  his  line  of  descent  with  himself.  We  have  indi- 
cated in  other  places  that  he  is  personally  a  menace  to  society 
while  alive. 

The  only  safe  procedure  is  custodial  and  institutional  care 
throughout  life  for  the  great  majority.  Some  authorities  believe 
that  a  small  percentage  of  those  who  are  trainable  may  after  a 
time  be  returned  to  society.  Even  these  are  usually  far  better  off 
in  an  institution  where  they  can  earn  a  living  under  watchful  care. 
In  the  paragraphs  that  follow,  we  shall  describe  the  type  of  insti- 
tution that  is  best  suited  to  such  lifelong  protection  of  these 
derelicts  in  society.  Sterilization  laAvs  and  other  means  of  pre- 
vention must  for  years  to  come  be  secondary  to  this  solution  of 
the  problem.  The  committee  on  eugenics  of  the  American  Breed- 
ers' Association  believes  that  if  every  State  would  provide  such 
colonies  for  all  its  defectives  and  socially  unfit,  two  generations 
would  relieve  us  of  almost  the  entire  burden  of  crime  and  financial 
outlay  caused  by  this  class. 

We  quote  first  descriptions  of  three  typical  cases  in  Texas  now 
needing  institutional  care. 

Mr.  Eeeves,  Eepresentative  from  the  Forty-second  District, 
Texas,  in  kindly  allowing  me  to  copy  this  letter,  writes :  "I  am 
enclosing  a  letter  that  explains  itself.  I  may  add  that  I  have 
had  a  great  many  communications  of  this  kind  from  different 
parts  of  the  State." 

*Smith,  Stevenson,  and  others,  A  Summary  of  the  Laws  of  the  Several 
States,  etc.,  Bull,  of  the  University  of  Washington,  No.  82,  May,  1914, 
pp.  82-83. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  61 

June  23,  1913. 
Hon.  I.  B.  Reeves,  Sherman,  Terns. 

Dear  Sir:  Of  course  I  am  not  one  of  your  constituent's,  hut 
I  am  very  much  interested  in  the  Reeves- Webb  bill  (of  which  I 
believe  you  are  one  of  the  authors)  which  the  Governor  vetoed. 
I  am  writing  to  earnestly  beg  you  to  use  your  best  influence  to 
have  the  Governor  submit  the  matter  for  legislation  at  the  coming 
extra  session. 

Our  oldest  child  is  mentally  defective,  and  it  is  a  matter  of 
impossibility  to  properly  care  for  and  train  her,  besides  the  extreme 
danger  to  which  our  two  younger  children  are  subjected.  The 
ceaseless  vigilance,  coupled  with  the  care  of  the  child,  is  a  task 
my  dear  wife  cannot  stand  many  years. 

Hoping  you  will  do  what  you  can,  and  that  I  may  hear  from 
you  soon,  1  am, 

Very  truly, 


P.  S. — Have  taken  this  up  with  my  own  Representatives,  also 
wrote  the  Governor. 

Two  Other  Cases  in  Texas  Needing  Institution  Care. 

Jennie — Chronologically  fourteen,  mentally  seven;  is  undersized 
and  anemic;  classified  second  grade;  trainable,  but  absolutely  un- 
defendable; edueably,  forgets  tomorrow  what  she  learns  today; 
easily  confused  and  never  able  to  straighten  a  mental  tangle.  She 
is  a  fairly  good  reader,  sews  well,  weaves  rugs  nicely,  washes  dishes 
and  dusts  creditably;  does  good  work  in  manual  training,  but  has 
to  be  told  step  by  step.  She  is  highly  excitable  and  very  nervous; 
has  very  little  muscular  control,  unsteady  gait  and  poor  lung 
capacity;  very  bad  teeth  and  slight  speech  defect;  is  of  sweet  dis- 
position and  fond  of  play.  Grandparents  on  maternal  side,  as  far 
as  known,  were  normal,  but  grandfather  alcoholic;  grandfather  on 
paternal  side  was  a  marked  f.  m.  He  married  a  normal  woman. 
They  had  three  normal  children,  one  immoral  daughter,  and  one 
feeble-minded  daughter  (who  was  the  family  drudge).  This  f.  m. 
daughter  married  a  feeble-minded  man.  They  have  four  f.  m. 
children  (two  boys  and  two  girls).  One  of  the  boys  is  a  wagon 
painter,  the  other  an  office  boy.    The  oldest  girl  went  as  far  as  the 


68  Bulletin  of  the  University  of  Texas 

fifth  grade  in  school,  and  Jennie  has  been  seven  years  making  the 
second  grade,  where  she  came  from  to  the  Special  Room. 

Sam — Chronologically  seventeen,  mentally  nine ;  height,  6  feet ; 
weight,  180  pounds  (physically  without  fault)  ;  classified  third 
grade ;  is  powerful  in  strength,  but  does  not  realize  it ;  will  never 
choose  any  but  a  little  boy  to  fight,  and  never  stops  to  investigate 
who  has  caused  the  trouble;  usually  he  kicks  or  hits  out  blindly 
when  annoyed  (as  he  constantly  is),  and  the  nearest  little  fellow 
gets  the  blow.  He  delights  in  drawing  trains  and  modeling  in 
clay;  will  sit  on  the  floor  hour  after  hour  with  a  chunk  of  clay 
modeling  Indian  heads,  or  will  paste  yards  of  drawing  paper 
together  until  he  has  enough  to  make  long  passenger  trains,  freight 
trains,  or  circus  trains.  These  are  very  accurate  in  every  detail. 
Sam's  paternal  grandmother  was  an  "artistic  crank"  and  his  father 
"had  the  mind  of  a  child"  until  he  was  twenty-one,  when  he  sud- 
denly got  all  right  and  became  brilliant.  He  afterwards  held  a 
very  responsible  position  in  a  big  wholesale  house  in  North  Texas. 
Although  Sam's  mother  insists  there  are  no  indications  of  feeble- 
mindedness on  her  side  of  the  line,  she  has  some  unmistakable 
characteristics.  She  has  made  three  very  indiscreet  marriages; 
first  husband  and  father  of  Sam,  an  acknowledged  f .  m. ;  second, 
a  worthless  drunkard,  whom  she  divorced,  and  third,  a  boy,  barely 
twenty-one  years  old.  By  this  last  marriage  she  has  one  little  girl. 
The  mother  makes  home  life  very  miserable  for  both  Sam  and  his 
stepfather.  She  is  the  terror  of  the  neighborhood,  because  of  her 
physical  strength  and  vile  tongue.  Her  business  sense  is  very 
shrewd.  -At  one  time  she  managed  a  farm  so  successfully  that  she 
was  able  to  buy  a  very  comfortable  home  with  the  profits.  After 
moving  to  town  to  live  she  secured  a  clerical  position  at  $100  per 
month,  which  she  held  until  her  third  marriage.  Sam  is  really 
an  institutional  problem,  to  whom  the  freedom  of  the  street  should 
not  be  allowed.* 

*Tlirough  the  kindness  of  Miss  Emily  Beavens,  who  has  charge  of  the 
Special  Room  in  the  Rusk  School  at  Houston,  I  quote  these  two  cases 
from  the  hundred  or  more  she  has  examined  in  the  course  of  her  work  in 
that  city.  Tire  names  are  fictitious.  Miss  Beavens  has  trained  herself 
especially  for  such  work,  and  so  far  as  the  writer  knows  her  room  rep- 
resents the  only  attempt  at  present  to.  meet  the  problem  of  the  feeble- 
minded in  Texas,  where  public  funds  are  used.  See  also  letter  to  Mr. 
Potts   quoted    above,    p.    60. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  69 

The  Colony, — Superintendent  Sessions  of  Davenport,  Iowa,  says 
some  observers  hold  that  where  all  the  feeble-minded  of  all  degrees 
from  the  idiot  to  the  moron  are  gathered  into  institutions,  the 
labor  of  the  highest  class  would  support  all.  No  Stale  or  com- 
munity has  had  the  courage  to  attempt  this,  therefore  no  one  is  able 
to  prove  or  disprove  absolutely  the  claim.  It  probably  would  not 
test  out  affirmatively.  It  is,  however,  a  definite  probelm  for  every 
State  in  the  Union  to  do  something  and  do  it  quickly  for  it-  feeble- 
minded population.  An  expert  in  Ohio  thoroughly  acquainted 
with  the  problem,  declares  that  if  the  State  give  him  2000  acres 
of  land  he  would  agree  to  care  for  all  their  feeble-minded  free 
of  charge. 

Twenty-six  States  in  the  Union  have  already  made  some  pro- 
vision for  their  feeble-minded  population.  These  twenty-six  States 
have  a  total  of  thirty-four  institutions;  New  York,  New  Hamp- 
shire, and  Connecticut  have  five  each.  There  are  about  the  same 
number  of  private  institutions.  Texas  boasts  one  of  these,  hut 
has  no  State  institution.  Its  private  institution,  loeated  at  Austin, 
maintains  meager  facilities  for  about  thirty  pupils  or  patients. 
In  some  of  the  more  advanced  States  of  the  East,  notably  Massa- 
chusetts and  New  York,  the  fame  of  their  institutions  is  world- 
wide. The  Royal  Commission  of  England  in  their  report  on  the 
feeble-minded  in  1908,  said:  "To  increase  the  resources  at  the 
local  authorities  for  dealing  with  cases  of  mental  defect,  and  for 
reducing  the  pressure  on  asylums,"  the  Commission  recommend 
"the  erection  of  intermediate  hospitals,  the  institution  of  large 
farm  colonies,  as  in  America ;  the  general  establishment  of  observa- 
tion and  reception  wards,  and  the  use  and  notification  of  private 
homes  for  the  treatment  of  'unconfirmed  cases.'  They  propose, 
also,  the  adoption  of  family  care  and  guardianship,  either  on  the 
plan  of  the  family  colony  in  force  on  the  Continent,  or  on  the 
plan  of  'boarding-out'  in  force  in  Scotland,  organized  in  connection 
with  the  local  authorities  for  the  care  of  the  mentally  defective, 
ami  under  the  inspection  of  the  central  authority."* 

In  detail,  the  Royal  Commission  refers  to  the  colony  system 
in  the  following  terms:  "Another  method  which  we  would  advo- 
cate is  the  introduction  of  the  large  farm  system  of  large  farm 

"Shuttle  worth   and  Potts,  Mentally  Deficient  Children,  pp.  2!)-30. 


70  Bulletin  of  the  University  of  Texas 

colonies  on  lines  suggested  to  us  by  the  colonies  for  the  feeble- 
minded which  have  been  established  in  the  United  States  of  Amer- 
ica and  in  Canada.  ...  In  America,  in  many  instances,  large 
estates  have  been  purchased,  which  give  scope  for  training  the 
mentally  defective  in  laboring  work  generally,  in  farm  work,  and 
in  horticulture.  In  some  of  these  estates  the  colonists  are  thor- 
oughly accustomed  to  manual  work,  and  are  capable  of  doing  a 
large  amount  of  hard  labor:  Thus  at  the  Templeton  Colony  in 
Massachusetts,  they  work  in  the  field,  break  rock,  and  drill  it  for 
blasting  with  explosives,  store  corn,  haul  bricks,  and  perform  many 
other  tasks  in  some  cases  even  without  supervision.  And  all  this 
is  done,  not  only  by  those  whom  we  would  call  'feeble-minded/ 
but  by  men  who  are  extremely  imbecile  or  idiotic,  and  who  have 
not  human  speech.  On  these  farm  colonies  there  is  ample  room 
for  experiment  and  development.  New  plans  of  education  can  be 
put  in  operation.  The  originality  of  the  teacher  may  find  new 
methods  of  testing  and  training,  and  there  is  space  and  opportunity 
for  different  kinds  of  employment.  Where,  as  usually  in  America, 
the  State  authority  is  careful  not  to  discourage  freshness  of  thought 
and  ingenuity,  quite  extraordinary  results  are  produced  on  these 
estates  by  men  whose  lives  are  devoted  to  the  care  of  the  mentally 
defective,  results  which  may  throw  light  even  on  the  methods  of 
education  that  may  be  suggested  for  the  education  of  normal 
scholars  in  public  elementary  schools.  The  establishment  of  (  one 
such  farm  colony  in  England  would  be  of  the  greatest  service,  both 
directly  and  indirectly."* 

The  State  of  New  York  has  begun  within  the  last  few  years 
what  is  probably  the  highest  ideal  for  such  an  institution.  Letch- 
worth  Village  is  situated  in  the  town  of  Haverstraw,  on  the  west 
bank  of  the  Hudson  Eiver,  and  three  miles  back  from  it.  It  con- 
tains 2000  acres.  The  farm  lands  comprise  about  1300  acres. 
The  territory  covered  by  the  whole  area  is  cut  in  two  by  a  creek, 
which  forms  the  line  of  segregation  between  the  boys  and  girls. 
On  the  west  side  the  groups  of  buildings  for  the  girls  and  women 
are  located,  and  on  the  east  side  there  are  the  dormitories  for  the 
boys  and  men.  We  may  illustrate  the  problems  involved  in  the 
care  and   training  of   the  "feeble-minded  by  the   arrangement  of 

*Op.  cit..  v.  8,  p.  237. 


Care  of  the  Fceb/e-mind&d  and  Insane  in  Texas  71 

buildings  and  grounds  in  this  village.  The  first  problem  was  the 
segregation  of  the  sexes.  This  is  done  absolutely  by  the  boundary 
lines  described  above.  In  establishing  the  buildings  and  their 
arrangement  several  problems  are  involved.  It  was  agreed  that 
none  of  the  buildings  should  be  more  than  two  stories  high,  nor 
should  they  contain  over  seventy  inmates.  In  ibis  village  the 
buildings  are  piaced  at  least  200  feet  apart,  leaving  sufficienl  space 
for  each  to  have  its  own  playground,  and  they  are  carefully  located 
with  regard  to  the  natural  beauty  of  the  place. 

The  Letchworth  Village,  as  planned,  is  an  institution  with  six 
separate  groups,  each  distinct  and  complete  in  itself  and  so  far 
removed  from  the  others  that  it  may  be  considered  a  small  insti- 
tution by  itself.  Each  group  contains  dormitories  arranged  in 
the  general  plan  of  the  horseshoe.  In  the  center  of  each  group  is 
located  the  kitchen  and  dining  room,  and  hall  used  for  gymnastics, 
dances,  entertainments,  and  Sunday  school.  Near  each  group  is 
an  attendant's  home  and  doctor's  house,  for  each  group  lias  a 
doctor  and  matron  in  charge,  who  is  responsible  to  the  superin- 
tendent. It  will  be  seen  that  there  are,  therefore,  three  groups 
for  each  of  the  sexes — one  for  the  young  and  improvable,  one  for 
the  middle-aged  and  industrious,  and  one  for  the  infirm  and 
helpless. 

The  plans  of  the  buildings  and  grounds  also  include  an  admin- 
istrative group,  hospitals  for  acute  cases,  and  laboratories  for  scien- 
tific investigation.  One  of  the  important  buildings  in  the  institu- 
tion plan  is  the  receiving  building  or  observation  building.  Here 
the  new  arrivals  are  all  placed  and  carefully  classified  before  being 
transferred  to  the  various  sub-groups.  The  purpose  of  such  an 
institution  is  fourfold.  First,  it  is  a  home  where  the  feeble- 
minded of  all  ages  may  be  given  the  pleasures  and  comforts  of 
the  ordinary  home.  All  of  the  clay  rooms  are  provided  with  games, 
colored  pictures,  flowers,  music,  etc.  Each  dormitory  has  its  own 
playgrounds,  where  are  baseball  diamonds,  football  grounds,  ap- 
paratus for  basketball,  croquet,  etc.,  and  swinging  hammocks  and 
picnic  grounds  are  provided  for  the  smaller  children. 

In  the  second  place,  the  institution  provides  a  school  where  suit- 
able training  can  be  given  to  all  of  school  age.  Suitable  training 
means,   of   course,   that  the   children   will   be   given  that  sort  of 


Bulletin  of  the  University  of  Texas 


Plate  XVII. 

Amusements  provided  for  inmates  of  such  colonies. 
The  Craig  Colony  for  Epileptics,  Sonyea,  W.  1.  See 
Tenth   Annual   Report,  opposite   p.   38. 


Care,  of  the  Feeble-minded  and  Insane  in  Texas 

training  which  will  be  of  most  benefit  in  aiding  them  to  support 
themselves  and  at  the  same  time  provide  them  with  such  mental 
and  manual  discipline  as  will  increase  their  enjoyment  in  their 
enforced  mode  of  life.  The  training  of  the  lower  grades  of  feeble- 
minded persons  must  consist  in  a  variety  of  active  gymnastic  exer- 
cises planned  to  stimulate  their  mental  processes  as  well  as  their 
physical  development.  A  routine  of  work  and  play  is  planned 
such  as  to  occupy  the  entire  day  not  needed  for  Bleep.  The  higher 
grades  receive  education  along  the  same  lines,  except  that  they  art- 
trained  to  be  finished  workers  for  the  State.  Besides  the  physical 
and  mental  training  described  above,  these  grades  are  given  indus- 
trial work  in  the  shops  and  a  variety  of  other  skilled  or  semi- 
skilled occupations.  It  is  necessary,  of  course,  to  consider  the 
finished  products  produced  by  such  students  and  workers  as  by- 
products, and  not  a  primary  purpose  of  the  institution.  The  in- 
stitution as  a  whole  must  be  looked  upon  as  a  school  where  every- 
one is  a  teacher,  and  the  personality  of  the  lowest  employee  is 
essential  in   the  management  of  the  institution. 

In  the  third  place,  such  an  institution  can  well  afford  to  be 
considered  as  a  laboratory  for  scientific  investigation,  and  social 
study.  It  is  obviously  necessary  to  obtain  the  history  of  the  fam- 
ilies of  the  children  who  come  to  such  an  institution.  We  must 
experiment  and  study  these  eases  before  we  can  hope  to  discover 
the  solution  of  the  many  problems  presented  by  such  individuals. 
The  institution  must,  therefore,  have  out  in  the  field  a  number 
of  trained  workers  who  are  gathering  family  histories  and  spread- 
ing throughout  the  State  information  and  knowledge  concerning 
the  institution  and  its  purpose.  These  trained  workers  must  re- 
port back  to  the  institution  and  their  work  must  be  collated  and 
systematized  by  workers  in  the  institution.  The  fourth  purpose 
of  such  an  institution  is  to  utilize  the  vast  amount  of  energy 
stored  up  in  these  feeble-minded  individuals.  It  is  an  axiom  that 
no  individual  can  be  happy  or  useful  unless  he  is  properly  busy. 
The  institution  thus  becomes  a  large  workshop.  These  men  and 
women  should  be  included  in  the  routine  of  outdoor  work.  It  is 
clear  that  the  farm  colony  arranged  under  such  a  plan  offers  the 
very  best  means  for  establishing  such  a  routine.* 

*Summary  of  arricle  in  Survey,  v.  27.  p.  1869f. 


74  Bulletin  of  the  University  of  Texas 

Extract  from  fourth  annual  report  of  the  board  of  managers 
of  Letch  worth  Village,  January,  1913,  pages  18-19 : 

"That  Letchworth  Village  is  already  beginning  to  serve  the 
purpose  for  which  it  is  established,  and  is  living  up  to  the  ideas 
of  the  man  in  whose  honor  it  is  named,  is  evidenced  by  the  happy 
and  contented  lives  of  the  inmates  now  in  its  care.  Further  evi- 
dence is  found  in  the  following  extract  taken  from  a  letter  recently 
written  by  a  relative  of  one  of  the  inmates  to  a  friend  in  Europe, 
and  a  comment  thereon : 

"  'The  day  is  dark  and  rainy,  so  I'll  enliven  it  by  telling  you 
about  A/s  visit  to  Letchworth  Village.  She  came  back  radiant, 
telling  us  that  B.  is  well  kept,  peaceful,  and  happy.  And  so  well; 
not  a  moment's  sickness.  And  he  said  if  she  did  not  need  him 
at  home,  lie  would  like  to  stay  on  and  see  how  he  liked  a  winter 
in  the  country.  A.  is  about  the  happiest,  most  grateful  woman 
on  this  continent,  bubbling  over  with  gladness.  B.  goes  to  the 
matron  as  lie  would  to  A.,  and  she  could  not  be  kinder  were  he 
her  own.  She  takes  care  of  his  clothes,  and  lets  him  help  her  as 
her'  right-hand  man.  There  are  certain  things  that  he  refuses  to 
do.  He  is  polite  about  it,  but  refuses.  For  instance,  he  will  wipe 
dishes,  but  refuses  to  wash  them.  But  the  matron  lets  him  do  as 
he  pleases.  He  finds  no  end  of  amusement  and  happiness  in  this 
busy  community  life.  A.  told  us  many  stories  which  show  the 
kindness,  the  personal  consideration  and  the  interest  by  which  B. 
is  surrounded.     Oh,  isn't  this  good? 

"  T  am  struck  by  the  tact,  consideration  and  good  sense  shown 
by  those  in  charge  of  Letchworth  Village.  No  such  hard  and  fast 
lines  that  a  weak-minded  man  cannot  have  his  fancies  gratified 
and  be,  therefore,  made  happy.'  " 

In  1891,  Mr.  Fish,  chairman  of  the  board  of  managers  at  Lin- 
coln, Illinois,  reported  to  the  National  Conference  of  Charities 
(page  105)  the  results  of  an  experiment  made  then.  In  1888, 
"they  leased  a  farm  of  four  hundred  acres,  about  a  mile  from  the 
main  institution."  Twenty  boys  were  permanently  located  there. 
In  1890,  they  added  another  hundred  acres  to  the  farm.  "Decem- 
ber 31,  1890,  the  account  with  the  farm  for  three  years  of  its 
occupancy  showed  a  balance  to  its  credit  of  $5848.47,  or  an  annual 
credit  of  nearly  $18   (?)  per  annum  above  all  expenses,  including 


Care  of  the  Feeble-minded  run/  Insane  in  Texas  75 

rent,  wages,  board,  and  6  per  cent  interest  on  the  plant.  The 
paid  employees  are  a  farmer  at  $50  per  month,  a  milkman  at 
$20  per  month,  and  a  maid  of  all  work  at  $12." 

One  of  the  first  plans  toward  the  establishment  of  such  a  village 
as  we  have  described  above  came  about  through  an  experimenl 
started  by  the  Massachusetts  School  for  the  Feeble-minded.  The 
Massachusetts  school  is  a  conventional  institution  for  defectives, 
following  the  older  methods  of  training  and  instruction  developed 
in  the  days  of  Seguin.  Not  long  ago  this  institution  discovered" 
that  instead  of  being  a  school,  it  was  rapidly  becoming  a  receptable 
for  chronic  adult  imbeciles  trained  to  the  extent  of  their  ability. 
The  inmates  had  no  outlet  for  their  activities  and  no  opportunity 
to  exercise  their  trained  capacity.  Many  of  them  were  able  to  do 
a  man's  work  under  proper  direction.  The  great  problem  arose 
concerning  the  disposition  of  such  a  class  of  individuals.  To  solve 
the  problem  the  trustees  of  the  institution  purchased  2000  acres 
of  land  in  the  northern  part  of  Massachusetts.  The  area  selected 
was  about  sixty  miles  from  the  original  institution.  In  the  sum- 
mer of  1899  they  transferred  fifty  of  their  adult  male  inmates  to 
this  estate. 

The  first  work  given  these  patients  was  the  preparation  of  a 
permanent  farm  group.  They  dug  cellars  for  the  dormitories,  wells 
for  water  supply,  put  in  the  sewage  plant,  and  gradually  fitted  one 
of  the  farms  for  permanent  occupancy.  At  the  end  of  the  summer 
of  1899  one  farm  group  was  practically  ready  for  its  inmates.  It 
is  interesting  to  note  how  well  this  colony  spent  the  winter  in  this 
cold  northern  climate.  During  the  first  winter  the  temperature 
was  often  25  degrees  below  zero.  Houses  were  all  heated  with  the 
old-fashioned  wood  stoves,  and  the  fuel  used  was  the  wood  cut  by 
the  boys  themselves.  They  worked  out  of  doors  all  winter,  and 
the  superintendent  of  the  colony,  Dr.  Fernald,  tells  us  that  there 
was  not  a,  case  of  illness  during  the  entire  season.  The  total  doc- 
tors' bill  for  the  winter  was  75  cents,  which  was  paid  for  a  minor 
surgical  operation. 

In  the  sjm'ng  another  group  of  fifty  boys  was  transferred.  At 
the  present  time  (1912)  there  are  four  farm  colonies  established 
on  this  tract  of  land.  These  colonies  are  all  approximately  the 
same  sizcj,  and  their  work  is  compared  with  each  other,  with  the 


76 


Bulletin  of  the  University  of  Texas 


result  that  wholesome  competition  is  established.  The  principal 
occupation,  of  course,  during  these  first  years  has  been  the  clearing 
of  the  land  and  the  cultivation  of  crops. 

In  the  few  years  that  the  farm  has  been  running  the  inmates 
have  cleared  over  200  acres  of  land — land  that  was  originally 
rough  woodland,  covered  with  stumps  and  bushes — and  removed 
large  and  small  stones.     This  practically  worthless  land  has  been 


Plate  XVIII. 

Inmates  at  work  in  Letchworth  Village,  N.  Y.     See  Fourth  Annual  Report  of 
Board  of  Managers,  opposite  page  24. 


transferred  into  fine  soil  ready  for  cultivation.  The  material  re- 
turns are  beginning  to  be  considerable.  In  1911  the  superin- 
tendent reports  that  they  raised  over  1300  barrels  of  apples,  6700 
bushels  of  potatoes,  and  620  tons  of  ensilage.  Twelve  full  car- 
loads of  food  products  were  shipped  to  the  home  school,  in  addi- 
tion to  the  vegetables  used  at  the  colony.  It  is  true  that  such  an 
institution    is   not   yet   self-supporting,   but   we   see   that    a   large 


Care  of  the  Feeble-minded  and  Insane  in  Texas  ',', 

amount  of  the  food  and  vegetables  used  by  the  community  can  be 
produced  by  the  inmates  themselves. 

The  actual  cost  of  the  buildings  and  furnishings  of  the  colony 
in  the  Massachusetts  institution  is  a  little  less  than  $200  per  capita. 
There  is  absolutely  no  comparison  in  com  fort,  contentment,  and 
health  between  the  hoys  out  at  the  colony  and  on  the  farm  and 
the  very  best  housed  patients  in  the  school. 

LEGAL   ENACTMENT   AND   STATE   POLICY  RELATING 
TO   FEEBLE-MINDED. 

The  platform  of  principles  of  the  Illinois  Charity  Law: 

"To  provide  humane  and  scientific  treatment  and  care  and  the 
highest  attainable  degree  of  individual  development  for  the  de- 
pendent wards  of  the  State. 

"To  provide  for  delinquents  such  wise  conditions  of  modern 
education  and  training  as  will  restore  the  largest  possible  portion 
of  them  to  useful  citizenship. 

"To  promote  the  study  of  the  causes  of  dependency  and  delin- 
quency and  mental,  moral,  and  physical  defects,  with  a  view  to 
cure  and  ultimate  prevention. 

"To  secure  the  highest  attainable  degree  of  economy  in  the  busi- 
ness administration  of  the  State  institutions  consistent  with  the 
objects  above  enumerated,  and  this  act,  which  shall  be  known  as 
the  code  of  charities  of  the  State  of  Illinois,  shall  be  liberally  con- 
strued to  these  ends."- — Laws  of  Illinois,  1909,  page  103f. 

Until  the  passage  of  the  Idiots  Act  of  1886,  the  feeble-minded, 
when  recognized  by  law  at  all,  were  treated  as  insane.  When  any 
attempt  was  made  to  treat  them  separately,  the  laws  naturally  pre- 
sented a  great  many  difficulties.  To  send  a  child  to  a  training 
school  necessitated  a  "long  and  formidable  array  of  legal  and 
medical  certificates''  such  as  were  required  to  imprison  the  insane. 
r]  he  asylums  in  England  harbored  at  that  time  several  thousand 
idiots  and  feeble-minded.  Ireland  says  of  their  condition  in  these 
asylums : 

''The  most  grievous  hardship  which  idiots  suffer  from  these 
enactments  is  their  imprisonment  in  lnnatic  asylums.  Naturally 
gentle  and  timid,  they  are  shut  up  in  the  same  wards  with  the 
insane,  people   subject  to   furious   fits  of  passion  and  dangerous 


78  Bulletin  of  the  University  of  Texas 

delusions,  and  whose  conversation  and  example  are  often  very  sug- 
gestive of  evil.  From  their  imitative  tendencies  they  soon  learn 
all  the  shameless  indecencies  brought  before  their  eyes.  They  pick 
up  oaths  and  imitate  the  wild  manners  of  the  insane.  The  med- 
ical superintendents  would  gladly  get  rid  of  them,  but  have  no 
power  to  refuse  them,  for  there  are  always  medical  men  to  certify 
that  they  are  idiots,  and  fit  persons  to  be  detained  in  a  lunatic 
asylum." 

The  Act  of  1886  provided  that  any  idiot  or  imbecile  while  a 
minor  may  be  placed  by  his  parents  or  guardians  in  any  hospital, 
institution,  or  licensed  house,  specially  designed  for  the  care  and 
education  of  this  class,  on  a  formal  certificate  of  his  infirmity 
given  by  a  registered  medical  practitioner;  after  the  age  of  twenty- 
one  years  he  may  still  be  continued  under  care  by  a  certificate  of 
a  medical  practitioner,  accompanied  by  a  statement  of  his  parents 
or  guardians.  This  detention,  however,  requires  the  written  con- 
sent of  the  commissioners  in  lunacy,  who  have  also  power  to  set 
free  such  persons,  stating  their  reasons  for  so  doing. 

In  1904,  a  royal  commission  was  appointed  to  investigate  the 
whole  problem  of  the  feeble-minded.  The  reference  required  them 
"to  consider  the  existing  methods  of  dealing  with  idiots  and  epi- 
leptics, and  with  imbecile,  feeble-minded,  or  defective  persons  not 
certified  under  the  lunacy  laws;  and  in  view  of  the  hardship  or 
danger  resulting  to  such  persons  and  the  community  from  insuffi- 
cient provision  for  their  care,  training,  and  control,  to  report  as 
to  the  amendments  in  the  law  and  other  measures  which  should 
be  adopted  in  the  matter,  clue  regard  being  had  to  the  expense 
involved  in  any  such  proposals  and  to  the  best  means  of  secur- 
ing economy  therein."  The  original  reference  was  extended  in 
November,  1906,  "to  inquire  into  the  constitution,  jurisdiction, 
and  working  of  the  commission  in  lunacy  and  of  other  lunacy 
authorities  in  England  and  Wales,  and  into  the  expediency 
of  amending  the  same,  or  adopting  some  other  system  of  super- 
vising the  care  of  lunatics  and  mental  defectives;  and  to  report 
as  to  any  amendments  in  the  law  which  should,  in  their  opinion, 
be  adopted." 

At  the  commencement  of  the  report,  which  appeared  in  1908, 
are  two  paragraphs,  which  describe  in  such  clear  and  telling  Ian- 


Care  of  the  Feeble-minded  and  Insane  hi.  Texas  79 

guage  the  present  unsatisfactory  state  of  affairs,  that  we  cannot 
forbear  from  quoting  them. 

"Of  the  gravity  of  the  present  state  of  things  there  is  no  doubt. 
The  mass  of  facts  that  we  have  collected,  the  statements  of  our 
witnesses,  and  our  own  personal  visits  and  investigations,  compel 
the  conclusion  that  there  are  numbers  of  mentally  defective  per- 
sons whose  training  is  neglected,  over  whom  no  sufficient  control 
is  exercised,  and  whose  wayward  and  irresponsible  lives  are  pro- 
ductive of  crime  and  misery,  of  much  injury  and  mischief  to  them- 
selves and  to  others,  and  of  much  continuous  expenditure  wasteful 
to  the  community  and  to  individual  families. 

"We  find  a  local  and  'permissive'  system  .of  public  education 
which  is  available  here  and  there  for  a  limited  section  of  mentally 
defective  children,  and  which,  even  if  it  be  useful  during  the  years 
of  training,  is  supplemented  by  no  subsequent  supervision  and 
control,  and  is  in  consequence  often  misdirected  and  unserviceable. 
We  find  large  numbers  of  persons  who  are  committed  to  prisons 
for  repeated  offenses  which,  being  the  manifestations  of  a  perma- 
nent defect  of  mind,  there  is  no  hope  of  repressing,  much  less  of 
stopping,  by  short  punitive  sentences.  We  find  lunatic  asylums 
crowded  with  patients  who  do  not  require  the  careful  hospital 
treatment  that  well-equipped,  asylums  now  afford,  and  who  might 
be  treated  in  many  other  ways  more  economically,  and  as  efficiently. 
We  find  also  at  large  in  the  population  many  mentally  defective 
persons,  adults,  young  persons,  and  children,  who  are,  some  in  one 
way,  some  in  another,  incapable  of  self-control,  and  who  are  there- 
fore exposed  to  constant  moral  danger  themselves,  and  become  the 
source  of  lasting  injury  to  the  community."* 

We  have  given  below,  page  47,  a  summary  of  the  early  history 
of  the  establishment  of  schools  and  institutions  in  the  United 
States.  At  the  present  time  only  thirteen  States  have  no  institu- 
tion for  the  feeble-minded.  Arkansas,  Florida,  Georgia,  Louisiana, 
Mississippi,  South  Carolina,  and  Tennessee  make  no  mention  of 
the  purely  mental  defective  in  their  laws.  New  Mexico  denies 
them  entrance  to  the  asylum  for  the  insane.  Alabama  and  Nevada 
permit  them  under  certain  conditions  to  be  committed  to  hospitals 
for  the  insane.     Nevada  permits  the  county  commissioners  to  make 

*Shuttle\vorth  and  Potts,  op.  cit.,  pp.  26-27. 


80  Bulletin  of  the  University  of  Texas 

arrangements  for  their  care  in  other  States,  and  Delaware  provides 
that  the  feeble-minded  of  that  State  shall  be  cared  for  at  State 
expense  in  the  Pennsylvania  institutions.  Nevada  and  Texas  place 
the  principal  duty  of  caring  for  the  feeble-minded  on  the  county 
commissioners.  This  means  in  Texas  that  those  who  cannot  care 
for  themselves  are  in  our  city  and  county  jails  and  on  the  poor 
farms  of  the  various  counties.  Others  are  at  home,  on  the  streets, 
and  an  uncertain  number  in  the  State  hospitals  for  the  insane  and 
at  the  Epileptic  Colony. 

A  bill  establishing  such  an  institution  was  introduced  in  the 
House  of  the  Texas  Legislature  in  January,  1913,  by  Beeves  and 
Webb,  House  bill  No.  376,  and  by  Nugent  in  the  Senate  at  the 
same  time,  known  as  Senate  bill  No.  187.  This  bill  (the  language 
is  the  same  in  both)  provides  for  an  institution  and  farm  colony  and 
for  suitable  training  facilities;  it  opens  the  doors  of  the  institu- 
tion to  air  feeble-minded  of  the  State  as  rapidly  as  provision  is 
made  for  them  by  legislative  appropriations.  The  bill  was  vetoed 
by  the  Governor  after  passing  both  houses.  It  is  weak  in  that  it 
fails  to  provide  for  the  extension  of  the  colony  by  permitting  the 
authorities  to  obtain  options  on  a  sufficient  body  of  land  to  meet 
all  demands  on  such  an  institution  for  many  years  to  come.  We 
have  four  institutions,  the  insane  hospitals  and  the  Epileptic  Col- 
ony, that  are  badly  handicapped  now  by  this  shortsighted  policy. 
The  Legislature,  however,  did  their  duty  with  regard  to  the  initial 
steps  in  the  problem  that  lies  before  them.  That  the  whole  duty 
of  the  State  must  wait  another  Legislature  is  attaching  no  blame 
to  the  law-making  body  of  Texas.  It  is  earnestly  hoped  that  Texas 
may  not  long  remain  in  the  list  of  States  enumerated  above. 

CONCLUSION. 

THE    BURDEN    OE    THE    FEEBLE-MINDED. 

"The  following  case  was  recently  submitted  to  a  well-known 
charity  organization  society  for  investigation  and  advice.  The 
family  is  not  dependent.  The  man  and  his  wife  have  been  the 
parents  of  thirteen  children  and  the  time  is  approaching  for  the 
birth  of  another  child.  Five  of  the  children  died  in  infancy, 
three  were  sent  to  the  State  Institution  for  Feeble-minded  (where 


Care  of  the  Feeble-minded  and  Insane  in  Texas  81 

one  of  them  died)  and  five  are  at  home.  The  father  is  industrious. 
earn?  good  wages  and  is  good  to  Ids  family,  but  the  mot  her,  while 
of  good  parentage,  is  feeble-minded  and  wholly  inefficient.  The 
home  of  this  family  is  indescribably  dirty,  and  the  children  are 
uncontrolled  except  when  the  father  is  at  home.  Our  of  the  five 
children  now  with  their  parents  is  a  feeble-minded  girl  fifteen 
years  old.  She  runs  loose  in  the  neighborhood.  Another  girl  is 
in  school,  hut  learns  slowly;  still  another  is  thought  to  lie  feeble- 
minded. Of  the  two  sons,  the  older,  who  has  a  bad  disposition, 
is  regularly  employed  for  wages.  The  younger  is  a  helpless  idiot 
and  epileptic."* 

The  feeble-minded  are  increasing  faster  than  the  general  popu- 
lation. The  principal  causes  of  this  defect  are  now  well  known. 
Appioximately  80  per  cent  of  cases  are  traceable  to  defects  in  the 
family  strain  of  one  or  both  parents.!  Our  social  values,  religious 
ideals,  political  theories,  and  economic  problems  alike  involve  a 
careful  and  serious  consideration  of  this  evil.  A  clean-limbed, 
pure-minded,  sane  thinking  people  is  an  ideal  alone  commensurate 
withe  the  ideals  of  this  State  and  this  nation.  What  shall  we  do 
to  attain;  to  eliminate  this  great  and  ever-increasing  source  of 
ignorance,  poverty,  and  crime?  "One  of  the  most  shocking  and 
easily  cured  evils  is  the  increase  of  the  feeble-minded,  the  begetters 
of  numerous  degenerate  children.  The  remedy  is  their  segrega- 
tion by  the  State,  especially  of  the  females."  %  The  answer  comes 
with  no  uncertain  ring.  We  must  stop  by  preventive  means;  there 
are  no  curative  agencies. 

The  general  problem  of  racial  betterment  is  broader  than  the 
one  we  have  set  ourselves  here.  The  program  is  far-reaching  and 
looks  not  only  to  the  reduction  of  unfit  social  strains,  but  also  to 
the  increase  of  those  proved  and  socially  valued  traits  of  character 
in  man.  This  problem  of  racial  betterment  is  called  in  modern 
phrase,  eugenics.  Our  purpose  in  this  discussion  has  been  limited. 
We  have,  therefore,  discussed  the  single  phase  of  the  general  prob- 
lem,— the  elimination  of  the  defective  strains.     Many  answers  and 

*Amos  W.  Butler,  President's  Address  before  National  Conference  of 
Charities  and  Corrections,  Minneapolis,   1907. 

fWhite  and  Jelliffe,  Nervous  and  Mental  Diseases,  v.   1,  p.   150. 

JClenn.  John  M.,  Director  Russell  Sage  Foundation:  "The  Church 
and  Social  Work."     N.   Conf.  C.  &  C,  Seattle,  1910. 


82  Bulletin  of  the,  University  of  Texas 

solutions  have  been  offered,  among  them  segregation  has  appealed 
to  society's  feelings  of  humanity  and  fair  play  with  greatest  force. 
Kestrictive  marriage  laws  and  customs  are  important,  and  edu- 
cative, but  fail  to  reach  the  irresponsible  and  degenerate  till  too 
late.  The  '"socially  inadequate"  are  so  named  just  because  they 
are  without  the  influence  of  law  and  order.  Eugenic  education, 
better  environment,  and  systems  of  matings  purporting  to  remove 
defective  traits  do  not  affect  the  impure  blood  and  inheritable 
factors  with  the  surety  necessary  to  eliminate  defects.  Laissez- 
faire  or  natural  selection,  euthanasia,  neo-malthusianism,  and 
polygamy  are  either  impossible  under  the  protective  forces  of 
modern  social  conditions  or  are  ideas  repugnant  to  present-day 
ideals  of  religion  'and  humanity.  Of  all  the  solutions  suggested, 
the  two  most  advocated  are  sterilization  and  segregation.  Both 
of  these  ideas  were  embodied  in  bills  submitted  to  the  last  Legis- 
lature in  Texas.* 

In  1911,  the  eugenics  section  of  the  American  Breeders'  Asso- 
ciation unanimously  adopted  the  following  resolution: 

"Besolved,  That  the  chair  appoint  a  committee  commissioned 
to  study  and  report  on  the  best  practical  means  for  cutting  off 
the  defective  germ-plasm  in  the  American  population."! 

The  evidence  so  far  collected  points  toward  segregation  as  the 
most  feasible,  most  easily  put  into  force,  and  least  subversive  of 
constitutional  prerogative.  However,  the  committee  referred  to 
published  a  model  sterilization  bill,  together  with  legal  argument 
and  detailed  annotations. %  The  committee  believes  "that  the  time 
allotted,  namely,  two  generations,  is  ample  for  cutting  off  the  in- 
heritance lines  of  the  major  portion  of  the  most  worthless  one- 
tenth  of  our  present  population,  if  the  recommended  program  be 
consistently  folowed."***  The  principles  of  such  a  law  are  con- 
ceived to  be  based  on  eugenical  motives  alone,  and  the  inmates  of 
all  eleemosynary  institutions  are  liable  to  examination.  Each  in- 
stitution head,  when  an  inmate  of  his  institution  comes  up  under 

*House  bill  No.  376,  Senate  Bill  No.  187,  and  Senate  Bill  No.   188. 

tBr.lletins  10A  and  10'B  of  the  Eugenics  Record  Office.  Cold  Springs 
Harbor,  Long  Island,  New  York,  dated  February,  1914,  comprise  the  first 
published   reports   of   the   committee's   work. 

tBulletin    10B,    p.    116   following. 

**Op.    eit.,    p.    150. 


Care  of  the  Feeble-minded  and  Insane  in  Texas 

the  law  Tor  dismissal,  must  furnish  the  data  required  to  a  eugenics 
commission  composed  of  experts  in  biology,  patholog}',  and  psy- 
chology. All  members  of  these  institutions  must  be  examined 
before  being  released,  and  all  sterilization  operations  are  ordered 
by  due  process  of  law  only.* 

Segregation. — The  trend  of  the  illustrative  data  and  the'  dis- 
cussion as  we  have  endeavored  to  outline  it  here,  are  overwhelming 
proof  of  the  necessity  for  custodial  care  and  oversight  for  all  feeble- 
minded. And  an  enlightened  and  far-sighted  policy  of  institution 
care  toward  tramp,  pauper,  and  inebriate  will  do  away  with  our 
antiquated  and  inadequate  system  of  workhouses,  almshouses,  or 
poor  farms,  and  jails, — the  uneconomical,  pitiful  failures  of  un- 
scientific, local  charity,  and  criminal  law.  Deep  and  abiding  char- 
ity gives  to  each  the  help  he  needs.  It  permits  all  to  live  under 
those  circumstances  best  suited  to  make  each  useful  and  happy. 
There  is  no  voice  in  Texas  raised  in  opposition  to  this  law.  There 
are  yet  too  few  persistently  raised  in  favor.  A  united  effort  now 
will  save  the  future  citizens  of  Texas  millions  of  dollars  in  money 
and  the  burden  of  past  sinning  generations  will  not  be  visited  on 
the  third  and  fourth  generations. 

The  immediate  policy  of  Texas  should  embody  ideas  gleaned 
from  the  best  and  widest  experience  available.  We  cannot  justify 
ignorant  and  unsatisfactory  legislation  with  the  modern  means  of 
communication  and  the  many  sources  e>f  information  readily  avail- 
able. Texas  should  proceed  by  establishing  legally  some  central 
agency  to  discover  the  facts  and  conditions  existing  in  the  State. 
This  central  agency  must  be  a  permanent  body,  lasting  so  long  as 
the  defective,  the  indigent,  and  the  social  weakling  exist.  Its 
prime  functions  must  be  study,  inspection,  and  the  spread  of 
scientific  and  thoroughly  proved  information.  The  first  recom- 
mendation made  by  the  Royal  Commission  in  England  after  a 
four-year  study  of  these  problems,  says:  "There  (should)  be  one 
central  authority  for  the  general  protection  and  supervision  of 
mentally  defective  persons  and  for  the  regulation  of  the  provision 
made  for  their  accommodation  and  maintenance,  care,  treatment, 
education,  training,  and  control."!     New  York  followed  sane  and 

*Op.  cit.,  p.  116. 
fOp.  cit.,  v.   8,  p.  323. 


84  Bulletin  of  the  University  of  Texas 

rational  methods  in  the  establishment  of  the  Letehworth  Colony. 
The  reports  of  the  commission  appointed  to  select  a  site  are  models 
of  the  extreme  care  and  careful  study  needed  to  use  the  State's 
resources  most  economically  and  efficiently.*  Texas  must  build 
institutions  for  the  training  and  custodial  care  of  her  feeble-minded 
youth  soon.  She  can  do  no  better  than  follow  closely  the  investi- 
gations mentioned  as  models  to  be  improved  on  rather  than  ignored. 

THE   INSANE. 

IMPORTANCE    OF    GENERAL    INFORMATION    ABOUT    THE    NATURE    OF 

INSANITY. 

We  may  easily  understand,  if  the  mind  is  subject  to  the  numer- 
ous defects  and  mal-co-ordinations  discussed  above  under  feeble- 
mindedness and  idiocy,  that  it  may  also  vary  widely  from  the 
healthy,  normal  mind  at  any  stage  in  its  growth  and  development. 
Such  disorders  of  mind  are  called  mental  diseases,  since  up  to  the 
time  of  their  appearance  the  individual  exhibited  all  the  charac- 
teristics of  the  average  human  being.  In  feeble-mindedness  some 
phase  of  mental  activity  varied  always  in  this  or  that  person  so 
classified,  but  mental  disease  means  precisely  the  same  change  in 
the  healthy  appearing  individual  that  occurs  when  the  organs  of 
the  body  function  badly,  as  in  attacks  of  heart  disease,  diabetes, 
or  when  infectious  maladigs  attack  the  bodily  structure  and  func- 
tions, as  in  fevers,  etc.  The  person  is  sick.  Often  he  is  little 
worse  off  than  lie  would  be  in  a  severe  attack  of  la  grippe,  and 
recovers  under  treatment  of  the  proper  kind  as  quickly.  In  other 
cases  the  disease  is  more  serious  and  frequently,  after  repeated 
occurrences,  becomes  chronic.  The  deliria  of  typhoid  fever,  of 
alcoholic  excesses,  etc.,  indicate  that  the  mind  may  be  affected  in 
the  course  of  diseases  whose  etiology,  course,  and  treatment  are 
well  known.  The  mystery  that  surrounds  insanity  or  mental 
disease  consists  largely  in  the  greater  respect  we  have  for  the  mind 
and  in  our  ignorance  concerning  its  phenomena  and  relation  to 
bodily  processes. 

Its  social  importance  rests  in  the  fact  that  mental  disease  of 
mild  or  severe  form  at  once  marks  the  person  suffering  therefrom 

*Keport  of  the  Commission  to  Select  a  Site  for  the  Eastern  New  York 
State  Custodial  Asylum,  Albany,   1908. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  8/5 

as  different.  •  He  cannot  any  longer  be  treated  as  a  fully  respon- 
sible member  of  society.  In  some  forms  of  mental  disease  the  sick 
man  or  woman  actually  becomes  dangerous  to  others  of  his  group. 
We  easily  generalize  such  instances,  and  insanity  becomes  too  often 
a  synonym  for  criminality.  It  cannot  be  emphasized  too  strongly 
that  the  proper  attitude  toward  mental  diseases  should  differ  in 
no  respect  from  the  attitude  maintained  by  intelligent  people 
toward  all  forms  of  sickness.  That  we  cannot  call  in  the  doctor 
and  see  the  disease  cured  under  our  own  eyes  does  not  alter  the 
situation.  In  reality,  it  brings  out  clearly  the  limitations  of  med- 
ical science,  the  inadequacy  of  our  hospital  facilities  and  methods 
of  treatment.  Many  other  diseases  besides  mental  diseases  bring 
these  limitations  as  forcibly  to  mind.  In  addition  to  this  igno- 
rance of  prognosis  and  treatment  we  must  remember  that  mental 
diseases  are  related  to  society  in  much  the  same  way  contagious 
diseases  are.  The  individual  suffering  from  mental  disorder  is 
not  only  sick  and  incapable  of  caring  for  himself,  but  in  many  of 
the  acute  mental  diseases  he  is  also  dangerous  to  his  family  and  to 
society.  So  long  as  we  cannot  in  the  present  state  of  medical  and 
social  science  determine  what  forms  of  insanity  are  of  this  dangerous 
type  we  must  watch  all  cases  with  the  same  care  that  we  exercise 
in  isolated  appearances  of  yellow  fever,  smallpox,  or  typhoid  fever. 
The  morning  paper  seldom  misses  an  issue  in  which  one  or  more 
instances  is  not  described,  wdiere  the  negligence  of  society,  the 
ignorance  of  early  symptoms  of  disease  have  resulted  in  suffering 
and  crime,  too  often  of  the  most  horrible  kinds. 

Although  differing  widely  in  many  instances  in  treatment  and 
nature  from  feeble-mindedness,  we  may  properly  discuss  insanities 
here.  Their  wide  prevalence  and  social  dangers  make  them  prob- 
lems of  State  polity.  Their  occurrence  during  adult  citizenship 
necessitates  State  interference  and  control.  Their  causes,  as  hered- 
ity, alcoholism,  social  disease,  social  madadjustment,  etc.,  bring 
mental  disorders  into  vital  relation  to  social  health  and  progress. 
Finally,  the  transition  from  mental  disorder  and  nervous  disease 
to  feeble-mindedness  and  mental  defect  is,  under  neglect  and  im- 
proper treatment,  often  but  a  few  short  generations  away. 


86  Bulletin  of  the  University  of  T.exas 

NATURE  OF  INSANITY. 

Definition. — Prom  the  above  we  may  see  'that  any  attempt  at 
accurate  and  definite  statement  regarding  mental  disease  must  fail. 
To  summarize  the  problems  involved  we  may,  however,  quote  Dr. 
White's  definition:  "Insanity  is  a  disorder  of  the  mind  due  to 
disease  of  the  brain  manifesting  itself  by  a  more  or  less  prolonged 
departure  from  the  individual's  usual  manner  of  thinking,  feeling, 
and  acting,  and  resulting  in  a  lessened  capacity  for  adaptation  to 
the  environment."* 

Peterson  gives  a  much  shorter  definition  covering  the  essential 
point  in  the  above:  "Insanity  is  a  manifestation  in  language  or 
conduct  of  disease  or  defect  of  the  brain." f  When  legal  consid- 
eration becomes  necessary,  definitions  are  usually  developed  bearing 
on  the  specific  legal  problem  presented,  for  example,  "in  a  lunacy 
inquisition  the  subject  of  the  inquiry  is  insane  if  he  is  incapable 
of  managing  himself  and  his  affairs." %  Many  other  definitions 
have  been  given  in  the  attempt  to  mark  out  the  field  of  mental 
disease,  or  for  social  or  legal  purposes.  These  will  suffice  to  indi- 
cate the  direction  taken  in  this  study  and  show  certain  boundaries 
of  mental  disease  forms. 

GENERAL   SYMPTOMS. 

All  mental  processes  may  exhibit  the  deteriorating  influences  of 
brain  disease.  Roughly  speaking,  these  may  be  grouped  as  dis- 
orders of  sensory  experiences,  of  emotions,  of  ideas,  and  of  actions. 
Disorders  in  sensory  fields  of  more  striking  character  are  hallu- 
cinations and  illusions.  Hallucinations  are  so  infrequent  in  nor- 
mal mental  conditions  that  they  may  practically  always  be  regarded 
as  symptomatic  of  transitory  or  serious  mental  disease.**  The 
patient  hears  voices;  sees  persons  and  objects;  smells  noxious  gases, 
smoke;  experiences  bitter  tastes;  extraordinary  movements  of,  and 
pains  in  internal  organs;  active  and  passive  movements  of  the 
body.  They  feel  as  if  they  were  floating  in  the  air,  or  as  if  they 
had   just   spoken,   etc.     Variations   in  the  feelings   of  health   are 

*White,  W.  A.,  Outlines  of  Psychiatry,  1909,  p.  14  f. 

tChnrch  and  Peterson,  Nervous  and  Mental  Diseases,   1909,  p.   654. 

tOp.  cit.,  p.  654. 

**Tanzi.   Text-Book   on   Mental   Diseases,   ch.   TV. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  8? 

frequent,  as  are  also  extremes  in  the  intensity  of  sensations.  Un- 
usual sensitivity  to  pain,  unusual  blunting  of  touch,  and  loss  of 
form  sensitivity  or  total  loss  of  power  to  feel  pain  often  occur. 
The  images  that  float  through  the  mind  may  fall  off  till  the  patient 
seems  to  wait  hours  before  a  new  image  appears  or  they  may  come 
with  bewildering  rapidity,  and  in  certain  cases,  absolutely  all  mem- 
ory pictures  for  definite  periods  of  time  may  be  lost. 

Another  striking  change  in  personality  occurs  in  the  emotional 
life.  Periods  of  deep  melancholy  and  depression  are  often  suc- 
ceeded by  periods  of  acute  excitement.  Apathy  to  the  extent  of 
withdrawal  from  all  active  interests  appears  or  the  patient  may 
exhibit  extreme  irritability  being  easily  and  through  no  adequate 
cause  thrown  into  fits  of  anger  and  rage.  One  patient,  a  paretic, 
described  his  case  to  me  with  considerable  evidence  of  suffering 
and  anxiety  over  his  condition.  He  said  he,  could  not  read  the 
papers  with  any  interest;  he  heard  of  his  brother's  death  without 
regret,  and  could  arouse  no  feelings  of  pleasure  or  pain  in  the  life 
about  him.  Yet  when  pleased  he  often  laughed  momentarily  or 
gave  evidence  of  impatience  by  the  usual  signs.  Inquiry  showed 
he  was  aware  of  the  change,  but  it,  so  he  said,  had  no  real  mean- 
ing for  him.  In  certain  diseases  the  patient  seems  to  withdraw 
from  all  ordinary  interests,  in  others  there  is  a  decided  euphoria 
often  accompanied  by  excited  and  momentary  interest  in  every- 
thing. 

Losses  of  memory  and  incoherence,  change  in  the  rate  of  flow 
■of  ideas  are  all  frequent  signs  of  serious  disorder.  I  quote  a  few 
lines  from  a  letter  handed  me  by  one  of  the  patients  in  the  Austin 
hospital:  "to  March  A  Dew  Bill  to  Editure  of  19014,  of  Sarah, 
Democrat,  Here  of  S.  E.  A.  of  14  years  and  Seven  months.  At 
Amarillo,  texts,  Baull,  B  A  C  Ces  of  my  Head  Word,  Boston  go. 
I  have  my  tongue  in  my  mouth  to  cast  out  my  association  with 
Hoo  said,  Boston,  Massachusetts,  United  States  after  me."  The 
losses  of  memory  frequently  include  the  loss  of  name,  occupation, 
residence,  thereby  entailing  serious  consequences  for  the  sufferer 
and  much  anxiety  on  the  part  of  friends  and  relations.  Delusions 
and  imperative  ideas  may  occur.  The  judgment  is  weakened  and 
ideas  of  grandeur  or  debasement  gain  control.  One  patient  de- 
scribes  herself  as  a  queen,   as  ready  for  heaven  with  her  wings 


88  Bulletin  of  the  University  of  Texas 

nicely  growing,  till  "those  persons  (attendants)  held  me  and  cut 
them  off."  Others  have  committed  the  unpardonable  sin;  others 
are  being  drained  of  their  life  blood;  some  have  untold  wealth, 
while  others  explain  their  condition  and  cheap,  untidy  clothes  by 
referring  the  listener  to  places  where  their  magnificent  clothing 
and  piles  of  jewelry  are  kept  locked  away  from  them  by  their 
oppressors. 

The  actions  and  physical  appearance  of  the  patient  correspond 
to  the  mental  state  roughly  outlined.  Exaggerated  stillness  and 
movement  go  with  melancholia  and  acute  mania.  Hallucinations, 
voices,  and  visions  are  commands  to  action  and  the  hallucinating 
insane  constitute  an  uncertain  class,  for  no  one  knows  what  new 
hallucination  may  suddenly  arise.  Grandiose  delusions  produce  in 
the  patient  the  proud  and  queenly  bearing  appropriate  to  them; 
fears  or  phobias  produce  characteristic  actions,  as  stammering,  tim- 
idity, trembling  with  loss  of  motor  control  over  walking,  standing 
erect  and  the  like,  when  the  patient  is  in  the  presence  of  the  feared 
object. 

Volumes  have  been  written  describing  the  details  of  these  mental 
abnormalities.  Enough  has  been  said  here  to  indicate  the  mean- 
ing intended  in  the  definition  of  insanity  above  quoted.  The  in- 
terested reader  is  referred  to  the  general  texts  on  mental  disease 
mentioned  in  the  bibliography  appended.  Description  fails  to  con- 
vey the  vivid  picture  and  strange  emotion  aroused  in  the  sane  at 
sight  of  one  whose  mind  is  seriously  disordered.  It  offers  no 
occasion  for  surprise  that  we  are  repelled  by  the  unusual  person- 
ality presented,  that  our  fore-fathers  burned  and  hanged  them  as 
witches  and  sorcerers,  or  believed  them  possessed  of  devils.  Today 
we  search  for  the  "Devil's  claw"  mark  as  they  did  in  Eevolution- 
ary  times ;  though  now  this  anesthesia  is  a  definite  symptom  of  the 
sick  person  in  need  of  treatment,  whereas  then  it  marked  him  a 
criminal,  engaged  in  the  black  arts. 

SOME    SPECIFIC   DISEASE   PICTURES. 

The  causes  and  symptoms  of  the  many  diseases  connected  with 
mental  disorder  are  as  yet  imperfectly  grouped  and  separated  from 
each  other.  It  is  certain,  however,  that  even  with  our  present- 
day  knowledge  we  can  no  longer  correctly  speak  of  insanity  as  a 


Care  of  the  Feeble-minded  and  Insane  in  Texas  89 

single  disease.  How  many  different  diseases  with  different  causes, 
remote  and  proximate1,  running  different  courses,  requiring  differ- 
ent treatment,  and  offering  different  chances  of  recovery,  rests 
with  time  and  the  energy  and  learning  and  opportunity  of  seri- 
ously minded  investigators  to  determine. 

As  illustrative  of  the  complexity  of  some  of  these  different  forms, 
I  want  to  describe  briefly  one  or  two  of  the  mental  diseases  that 
are  most  clearly  defined.  One  of  the  more  interesting  of  these 
mental  disease  complexes  is  that  known  as  paranoia.  The  prime 
characteristic  of  this  disease  is  the  presence  of  delusions  and  hal- 
lucinations. Simpler  types  of  this  disease  are  present  in  the  queer 
and  eccentric  individuals  that  we  commonly  call  cranks.  They 
exhibit  the  essential  features  of  this  disease,  although  in  quite  an 
undeveloped  form. 

It  is  not  my  purpose  to  give  here  in  any  scientific  detail  the 
clinical  outlines  of  a  case.  We  can  only  understand  the  entire 
situation  by  long  study  and  actual  clinical  examination  of  many 
cases;  for  the  student  of  mental  diseases  such  a  description 
would  be  presumption  on  my  part  and  for  the  rest  of  us  who  are 
not  conversant  with  the  technical  terms  that  must  necessarily  be 
used,  futile.  A  simple  statement  of  the  typical  delusions  must, 
therefore,  suffice. 

Paranoia  ordinarily  has  a  number  of  different  periods.  The  pre- 
liminuary  period  or  what  is  technically  known  as  the  prodromal 
period,  is  the  period  of  subjective  analysis,  where  the  patient  at- 
tempts to  examine  or  analyze  his  own  thoughts  in  detail,  and  while 
so  doing,  tends  to  withdraw  himself  from  the  companionship  of 
others.  There  is  also  a  distinct  tendency  in  this  period  to  imagine 
all  kinds  of  diseases  and  troubles  as  peculiarly  one's  own.  This 
tendencj'  to  withdraw  and  to  look  at  one's  own  thoughts  naturally 
brings  to  light  a  great  many  of  the  ordinary  sensations  and  move- 
ments of  the  body  that  in  the  healthy  growing  boy  or  girl  are 
never  noticed.  The  unnaturalness  of  sparks  and  dots  before  the 
eyes,  of  pains  in  various  parts  of  the  body,  now  noticed  for  the  first 
time,  lead  him  to  believe  that  he  is  different  from  others  and 
suffering  perhaps  the  beginnings  of  many  diseases.  A  natural  con- 
sequence of  withdrawal  from  other  people  is  that  they  also  tend 
to  withdraw  and  let  the  patient  alone  more  and  more.     This  in- 


90  Bulletin  of  the  University  of  Texas 

tensifies  the  sense  of  apartness  that  is  growing  np  in  the  mind  of 
the  patient.  He  begins  to  feel  that  not  only  are  they  paying  little 
attention  to  him,  but  what  attention  they  do  give  is  mischevious 
and  vengeful,  and  he  finally  becomes  suspicious  of  anyone  who 
looks  in  his  direction.  The  growing  changes  in  him  naturally 
provoke  attention  to  him,  and  the  vicious  circle  continues.  Un- 
usual and  unpleasant  odors  and  tastes  appear.  At  first  confused 
voices  are  heard;  later  these  gradually  take  on  form  and  become 
the  voice  of  some  person  speaking  to  him,  and  mold  themselves 
into  words  with  various  meanings. 

The  patient  now  enters  the  second  stage  of  the  disease.  This  is 
technically  known  as  the  persecutory  period  of  paranoia.  The 
logical  tendency  of  the  mind  has  finally  asserted  itself  and  all 
these  hallucinations  of  sight  and  sound  and  strange  odors  are 
gradually  arranging  themselves  in  the  order  of  cause  and  effect. 
The  mind  of  the  patient  has  gradually  come  to  believe  that  these 
are  distresses  and  afflictions  that  he  is  suffering  because  of  un- 
known enemies.  Naturally  the  persecutory  element  is  at  first  con- 
fused and  the  persons  who  are  causing  him  all  these  afflictions  are 
unknown.  He  uses  the  words  "they,"  "someone,"  "the  voice," 
and  similar  means  of  expression  to  indicate  this  vagueness  of 
localization  and  of  person.  As  the  delusions  become  more  fre- 
quent the  cause  and  effect  relation  also  becomes  more  evident,  and 
he  detects  in  all  individuals  that  attract  his  attention  the  persons 
who  are  producing  these  troubles.  Usually  those  things  that  are 
known  and  whose  real  meaning  is  unknown  are  selected  first. 
Masons  or  Odd  Fellows,  Catholics  or  Protestants,  anarchists  or 
police,  are  persecuting  him  and  threatening  him  with  all  kinds  of 
punishment.  The  cause  of  his  afflictions  becomes  still  more  defi- 
nite, and  soon  the  patient  feels  that  he  can  recognize  the  voice 
of  the  person  speaking.  He  feels  that  he  is  certain  that  persons 
whom  he  can  name  are  doing  all  these  things.  He  also  has  a  clear 
and  elaborate  explanation  of  the  reasons  for  their  persecutions. 
As  this  conviction  becomes  more  and  more  definite  we  find  him 
appealing  to  the  police,  to  persons  in  authority,  oftentimes  to  the 
Governor,  or  even  to  the  President,  to  have  these  persons  whom 
he  names,  imprisoned  and  punished.  Frequently  he  attempts  to 
punish  them  himself. 


Care  of  ike  Feeble-minded  and  Insane  in  Texas  91 

The  third  stage  of  this  disease  is  the  expansive  period.  In  this 
period  the  person's  personality  is  frequently  transformed.  The 
transformation  takes  place  in  the  direction  of  the  persecutory  de- 
lusions. The  argument  runs :  "If  these  people  persecute  me  and 
attempt  to  injure  or  kill  me,  then  they  must  have  some  definite 
reason  for  it.  But  persons  are  not  persecuted  or  injured  unless 
they  are  of  importance  or  someone  has  good  reason  to  wish  them 
out  of  the  way.  Therefore,  I  must  be  of  importance  since  I  am 
persecuted/'  and  so  on.  For  example,  one  patient  would  consider 
himself  as  of  royal  descent,  and  those  persons  who  are  persecuting 
him  are  concealing  the  facts  from  him,  and  are  attempting  to 
destroy  him  or  to  take  his  rightful  position  and  use  his  wealth. 
However,  these  delusions  may  connect  themselves  with  almost  any 
idea  of  the  same  inind.  Some  may  be  political;  others  are  con- 
nected with  affairs  of  ordinary,  daily  life.  Persons  are  trying  to 
poison  their  food  or  are  stealing  their  candy,  sugar,  and  money. 

In  melancholia  we  have  quite  a  different  picture.  This  disease 
lays  greatest  stress  upon  the  emotions  and  feeling  processes  of 
the  mind.  The  state  may  vary  from  ordinary  simple  dejection, 
•  where  all  of  one's  thoughts  have  a  painful  tone,  to  a  condition  of 
most  profound  depression,  where  the  patient  seems  actually  par- 
alyzed by  the  terrible  nature  of  his  ideas.  The  behavior  of  the 
different  patients  naturally  varies.  Some  will  become  still  and 
quiet  under  the  depressing  influence  of  their  grief,  while  others 
make  many  demonstrations,  weeping,  wailing,  and  calling  out  for 
help.  In  the  apathetic  form  of  melancholia  the  patients  claim  that 
they  have  no  feeling  at  all.  They  have  left  no  love  for  home  or 
family,  and  they  can  never  hope  to  be  sad  or  happy  again.  When 
hallucinations  are  present  they  frequently  affect  all  the  senses  and 
are  usually  horrible  in  the  extreme.  A  peculiar  form  that  this 
grief  and  sorrow  may  take  is  that  the  patients  often  feel  them- 
selves, not  as  sick,  but  as  wicked.  They  have  committed  sins 
against  God  and  society.  They  are  going  to  be  punished,  killed, 
or  put  in  prison.  "Thus,  they  come  to  delusions  that  are  some- 
what similar  to  persecutory  ideas  in  that  they  believe  that  the 
officers  of  the  law  are  after  them,  etc.  This  is  different,  however, 
from  the   true  persecutory  delusions,  in   which  patients  have  no 


92  Bulletin  of  the  University  of  Texas 

self-depreciatory  ideas,  but  believe  themselves  to  be  the  innocent 
victims  of  inimical  conspiracies."* 

EARLY  SIGNS  OF  NERVOUS   WEAKNESS. 

It  is  impossible  to  describe  in  detail  any  number  of  the  mental 
pictures  of  the  numerous  varieties  of  brain  disease.  In  giving 
the  two  simple  clinical  pictures  above  we  have  siniply  endeavored 
to  illustrate  as  briefly  as  possible  some  of  the  essential  features  in 
certain  mental  diseases.  The  person  afflicted  with  mental  disease 
is  assumed  to  have  been  an  active  member  of  society,  engaged  in 
business  and  meeting  his  domestic  and  economic  responsibilities 
in  the  ordinary  way.  It  is  the  misfortune  of  some  people  to  fall 
victim  more  easily  to  some  mental  affection  rather  than  to  fever, 
cancer,  or  other  physical  disease.  In  many  instances  the  causes 
that  produce  mental  disease  are  precisely  the  same  as  the  causes 
that  in  another  person  produce  the  physical  disease.  For  example, 
a  great  mairy  of  the  functional  derangements  of  the  nervous  sys- 
tem are  complicated  b}T,  or  originate  in,  toxic  conditions.  One  of 
the  most  important  and  immediate  causes  of  the  rise  of  mental 
symptoms  is  exhaustion.  These  so-called  exhaustion  psychoses  in- 
clude a  series  of  diseases  that  are  commonly  spoken  of  as  deliria, 
stupor,  mania,  melancholia,  or  confusional  insanities.  We  are  ac- 
customed to  describe  this  general  cause  as  worry,  a  simple  trouble 
in  the  beginning,  but  when  continued  long  enough  in  any  individ- 
ual, brings  on  a  more  or  less  serious  mental  condition. 

Besides  exhaustion,  another  of  the  preliminary  indications  of  an 
overtaxed  nervous  system  and  a  symptom  fraught  with  the  pos- 
sibilities of  mental  disease  is  insomnia.  Insomnia  is  always  a 
manifestation  of  irritability,  and  is  probably  an  early  symptom  or 
expression  of  exhaustion.  "It  indicates  that  the  excessive  momen- 
tum in  the  work  of  the  day  is  carried  into  the  night  and  that 
normal  relaxation  and  recuperation  do  not  follow."  The  patient 
states  that  his  thoughts  are  running  away  with  him.  This  mental 
unrest  becomes  a  source  of  anxiety,  and  very  frequently  our  patient 
attempts  to  relieve  his  insomnia  by  the  use  of  drugs  and  various 
forms  of  sedatives.  The  patient  is  often  conscious  of  strange 
thoughts    and   feelings    and  is   frightened   at   their   extraordinary 

*Peterson,  op.  cit.,  p.  794. 


Care  of  Uw  Feeble-minded  and  Insane  in  Texas  93 


[sylnm  (are  vs.  Hospital  Treatment 

Treatment  of  excited  patients 

',?'  .«     ♦:■■■■ 


Horses  illustrating  use  of  res f mint  apparatus 

(abando7t£ci  in  att  enligfiteTi&L  hospi£aJLsJ 


:   /l7//r/?/  />/  contimwus  balk  of  tepid  miter 

L.  /  often,  jescci  cxtntinumzsLtf  Jvr,  <X&u/-$  C*r-j,£/ee&>S~}- 

Plate  XIX. 

Handbook  of  the  Mental  Hygiene  Movement  and  Exhibit,  New  York, 

Chart  No.  29. 


94  Bulletin  of  the  University  of  Texas 

character.  He  is  assailed  by  strange  and  unexplained  fancies;  his 
bodily  sensations  are  perverted  and  novel;  he  reacts  in  an  unusual 
wav  to  external  impressions  and  mistakes  the  attitudes  and  pur- 
poses of  his  friends.  The  particular  signs  of  mental  disease,  the 
special  term  that  we  apply,  persecution,  obsession,  phobia,  or  hys- 
terical attack  that  the  individual  case  presents,  matters  little.  It 
is  enough  to  know  that  our  patient  is  sick  just  as  he  may  be  sick 
in  any  other  form  of  disease  and  is  curable  in  many  instances  in 
the  same  way.  He  is  willing  to  accept  the  physician's  explanation 
of  the  disease  in  the  early  stages,  and  we  commonly  describe  the 
disease  at  this  point  as  the  "borderland  of  insanity." 

This  is  the  moment  when  treatment  should  begin.  His  friends 
and  relatives  should  recognize  the  condition  in  which  he  is,  and 
tell  him  frankly  and  plainly  that  treatment  is  necessary,  and 
believe  that  he  can  be  cured  if  treated  now.  This  last  statement 
cannot  be  emphasized  too  strongly.  We  are  accustomed  to  think 
of  the  man  who  is  insane  or  troubled  with  mental  vagaries  of 
any  sort  as  being  wholly  incurable.  In  other  words,  we  have 
thought  of  all  mental  disease  as  chronic.  This  is  decidedly  not 
the  case.  Our  own  asylums  in  Texas  give  a  percentage  running 
above  forty  of  recovered  and  discharged  ones.  The  New  York 
hospitals  find  that  their  percentage  is  almost  the  same.  Where 
the  diseases  are  treated  in  the  very  first  stages  a  very  much  larger 
percentage  of  cases  is  recoverable.  In  pavilion  F  of  the  depart- 
ment for  mental  diseases  of  the  Albany  Hospital  from  1902  to 
1907,  1031  patients  were  received.  Of  these  596  returned  to  their 
homes  recovered  or  improved;  316  remained  stationary,  and  86 
died.     This  is  recovery  in  57  per  cent  of  the  cases. 

As  soon  as  all  physicians  and  psychologists  and  more  parents  and 
teachers  learn  to  recognize  the  early  clanger  signals  of  nervous  dis- 
orders in  children  and  young  people,  we  may  hope  for  still  better 
results  in  prevention  and  cure.  Defects  of  nervous  constitution,  bad 
habits  of  living,  uncontrolled  impulses,  and  untrained  tendencies 
are  often  preliminary  signs  of  coming  trouble.  Whether  they  lead  to 
insanity  or  not  in  the  particular  case  is  not  important;  it  is  enough 
to  know  that  the  peculiarities  of  the  mentally  diseased  are  not 
suddenly  manifested.*    They  may  be  traced  back  to  earlier  defects 

*Dr.  A.  Hoch,  Early  Manifestations  of  Mental  Diseases,  Proceedings  of 
Mental  Hygiene  Conference,  1ST.  Y.,   1912. 


Care  of  the  Feeble-mincl&d  and  Insane  in  Texas  95 

in  self-management,  to  traits  and  deformities  of  action  in  individ- 
ual life  histories  and  in  the  family  tree.  Prevention  is  always 
preferable  to  treatment  and  cure.  Studies  of  families  and  individ- 
uals here  take  the  place  of  investigations  into  water  supply,  milk 
supply,  mosquito  swamps,  and  the  many  other  sources  of  physical 
disease. 

Illustrating  the  urgent  need  for  better  facilities  for  the  treat- 
ment of  the  borderline  cases  and  pointing  out  a  decidedly  weak 
spot  in  our  State  medical  profession,  the  following  case  is  of  in- 
terest.    The  story  is  vouched  for  by  a  salesman  of  the  M 

Co.,  Dallas.  The  first  signs  of  trouble  came  when  this  man,  an 
experienced  and  successful  salesman,  became  forgetful.  He  would 
leave  his  sample  cases  and  have  to  spend  ten  and  fifteen  dollars 
to  find  them.  This  difficulty  finally  became  so  bad  that  the  officers 
of  the  company  suggested  he  take  a  year's  vacation  and  rest  to 
see  if  he  could  not  get  well. 

Instead  of  getting  better  the  man  steadily  became  worse.  He 
became  suspicious  of  the  bank  where  he  kept  his  money  and  drew 
it  all  out.  This  monejr  he  carried  in  a  large  package  of  bills  in 
his. coat  pocket.  Sometimes  he  would  stand  for  an  hour  or  more 
on  the  street  taking  this  roll  out  of  one  pocket  and  putting  it  in 
another.  He  would  change  his  letters  from  one  pocket  to  another 
also,  and  during  the  whole  time  never  attempted  to  count  the 
money  or  read  the  letters.  Finally  one  day  he  walked  into  a 
blacksmith's  shop  and  began  to  gather  up  the  tools.  The  smith 
remonstrated  and  the  man  became  angry.  He  told  the  smith  that 
he  (the  smith)  had  stolen  all  these  tools  and  it  was  his  (the 
patient's)   duty  to  return  them. 

In  his  endeavor  to  get  well  this  man  had  as  many  as  five  physi- 
cians treating  him  for  different  diseases  at  one  time.  After  his 
money  was  gone  he  was  at  last  committed  to  an  asylum.  This 
illustration  is  not  an  isolated  one  in  Texas.  The  ignorance  of 
the  medical  profession  is  largely  responsible  for  the  long  delay  in 
reaching  adequate  treatment.  And  our  State  laws  only  aggravate 
the  difficulty. 

CAUSES  OF  INSANITY. 

The  distinction  between  nervous  diseases  and  insanity,  and  even 
the  distinction  of  organic  disease  and  brain  disease,  fail  in  many 


96  Bulletin  of  the  University  of  Texas 

borderline  cases.  The  influences  that  modify  brain  activity  and 
mental  process  are  many  and  varied.  In  speaking  of  causes  of 
insanity  we,  therefore,  must  limit  our  discussion  more  particularly 
to  those  influences  that  appear  most  frequently  in  connection  with 
mental  disease  or  that,  at  present  seem  most  closely  allied  to  habit 
and  conduct,  to  ways  of  thinking  and  feeling.  Peterson  sums  up 
the  chief  factors  in  the  causation  of  insanity  in  two  words — "hered- 
ity and  strain.'""  Under  the  first  he  includes  direct  inheritance  and 
the  many  "hereditary  equivalents,  such  as  epilepsy,  chorea,  hys- 
teria, neurasthenia,  somnambulism,  organic  diseases  of  the  central 
nervous  system,  criminal  tendencies,  eccentricities  of  character, 
drunkenness,  etc.,  for  these  equivalents  are  interchangeable  from 
one  generation  to  another,  and  are  simply  evidences  of  unstability 
of  the  nervous  system."*  Under  strain,  he  brings  together  two 
sorts  of  causes,  the  physical  and  the  moral.  By  physical  he  means 
the  use  of  alcohol,  bodily  diseases  and  disorders,  accident  and 
injury,  old  age,  the  puerperal  state,  menopause,  etc.;  and  under 
moral  strains  are  included  grief,  domestic  trouble,  business  Avorry, 
overwork,  religious  excitement,  love  affairs,  fright  and  nervous 
shocks,  f 

These  three  factors,  heredity,  physical  ill-health,  and  worry, 
probably  produce  all  insanities  as  their  causes,  in  about  the  pro- 
portion of  GO,  26,  and  1-1  per  cent.  These  percentages  are  highly 
variable,  both  because  of  insufficient  data,  and  because  the  influ- 
ence of  a  factor  is  not  constant  in  the  production  of  a  particular 
disease.  We  quote  below  a  table  from  the  New  York  State  Com- 
mission in  Lunacy  for  the  year  ending  September  30,  1911:* 

A.     Psychoses  with  a  High  Percentage  of  Cases  with  Family  His- 
tory of  Insanity  or  Nervous  Diseases. 
Psychosis.  Per  Cent. 

Dementia   praecox    59.2 

Involution  melancholia    61.6 

Alcoholic    51.2 

Allied  to  manic  depressive 56.7 

Epileptic    - 60.2 

*Op.  cit.,  p.  701. 
fOp.  cit.,  p.  724. 
JEugenics  Record  Office,  Bulletin   No.    10A.   p.   30. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  97 

Psychosis.  Per  Cent. 

Hysterical,  psychasthenic,   neurasthenic 61.9 

Other  constitutional  disorders  and   inferiorities 57.8 

Imbecility,  and  idiocy  with  insanity 58.5 

B.     Psychoses  with  a  Low  Percentage  of  Cases  with  History  of 
Insanity  or  Xervous  Diseases. 
Psychosis.  Per  Cent. 

Senile 41.7 

Dementia  paralytica 38.4 

Infective,  exhaustive  and  auto-toxic 41.7 

Allied  to   infective-exhaustive 33.3 

Paranoic  conditions    40. 1 

Depressive  hallucinoses   37.5 

Eosanoff  and  Orr  made  an  extended  study  of  72  families,  rep- 
resenting 206  different  matings,  with  a  total  of  1097  offspring. 
The  fundamental  condition  from  which  "mental  disorder  might 
originate  is  defined  as  the  neuropathic  constitution.  It  was  found 
that  many  clinical  types  might  result  from  matings  in  which  this 
constitution  figured.  On  the  basis  of  this  neuropathic  character 
a  study  of  the  material  showed  that  of  the  total  number  of  off- 
spring, 351  were  neuropathic,  while  the  calculation  on  the  basis 
of  the  Mendelian  proportions  indicated  a  theoretical  expectation 
of  359/  Of  the  total  number  of  offspring  the  actual  number  that 
were  normal  was  586,  while  the  theoretical  expectation  was  578. 
This  will  be  seen  to  be  a  remarkably  close  approximation  as  be- 
tween the  actual  findings  and  the  theoretical  expectations."* 

The  technical  aspects  of  heredity  laws  need  not  concern  us  here. 
Peterson  summarizes  from  Mercier  the  principal  operations  of 
inheritance  from  which  we  may  quote  a  few  illustrative  laws.  The 
child  tends  to  inherit  every  attribute  of  both  parents;  contradictive 
attributes  cannot  be  inherited  from  both  parents;  it  may  inherit 
the  attributes  of  either  parent  solely;  some  attributes  are  pre- 
potent, overruling  others;  some  are  cumulative;  others  may  be 
latent  in  one  generation,  etc.f 

*White  and  Jelliffe,  op.  cit.,  v.   1,   p.  43. 

tOp.  cit.,  pp.  701-2.  Cf.  W.  &  J.,  op.  cit..  v.  1,  pp.  44-46,  for  a  more 
detailed   statement. 


98  Bulletin   of  the   University  of  Texas 

Airain  the  limits  of  space  must  constrain  us  from  discussing  the 
effects  of  drugs,  auto-intoxication,  syphilis,  sexual  perversions,  and 
the  moral  factors  mentioned  above.  The  paretic  with  Ms  syphilitic 
history  is  found  in  every  commrmity.  In  1911  there  were  590 
deaths  from  general  paresis  in  Yew  York  State  alone.  In  the 
same  year  there  were  134  deaths  from  smallpox  in  the  entire 
United  States.  Yet  we  welcome  the  cause  of  the  first  in  our 
ignorant  sex  ideals  and  shun  the  appearance  of  the  other.  More 
deaths  occur  in  that  State  from  paresis  each  year  "than  from 
ilvsenterv.  malaria,  smallpox,  tetanus,  and  rabies  all  combined." 
Syphilis  has  been  shown  to  be  the  cause  of  many  ease?  of  fc 
mindedufss.  nervousness,  infantile  paralysis,  certain  forms  of  epi- 
lepsy, arterio-seleiosis  and  many  other  forms  of  disease  and  de- 
formity. Here  is  a  dangerous,  contagious,  and  infections  eh-  - 
with  no  agency  fighting  it  as  exists  to  lessen  other  communicable 
diseases  like   smallpox,   diphtheria,   scarlet   fever,   or  tuberculosis. 

Alcohol  is  the  direct  cause  of  at  least  five  distinct  mental  dis- 
orders,   delirium    tremens,    alcoholic   epilepsy,    alcoholic   dem. 
acute  alcoholic  hallucinosis,  and  polyneuritic  psycho-  -       [t  is  un- 
doubtedly the  exciting  eause  in  a  number  of  others.     Ten  per  rent 
of  the  5700  admissions  to  the  Yew  York   State  hospitals  during 
the   vear   ending   September.   1911,   were   suffering  from  alcoholic 
insanity  in  one  form  or  another.*-    The  relation  of  alcohol  t 
lepsy.  feeble-mmdedness.   and  all  forms  of  neuropathic  -disorders 
is  always  one  of  dangerous  etiology.     The  tale  of  woe  an 
is  not  told  when  poverty,  crime,  drunkenness,  and  broken  homes 
are  added  together.     The  next  generations  must  also  suffer  through 
early   death,  mental   and  physical   defects,   and  manifold  nervous 
disorders. 

The   problem   of   alcoholism,  like   heredity,  is   social   as  well  as 
medical.     Medical  treatment  when  the  diseases  are  at  thei  .    : 

is   necessary;   it   involves   careful  case  histories  and   demands  "in- 
dividual study.     Custodial  care  is  essential  in  many  cases  and  per- 
manent   confinement    indicated   in    all    pathological    drunkem    •- 
The   social  problems  are  numerous  and  constitute  serious  phases 
of  public    health   and   safety.     The  limits   of  space  alone  prevent 

*Elhv<>od.  E.   S..  Alcohol   and  Insanity.   Report    of  Mental  Hygiene  Con- 
gress, X.   Y..    1912.   p.   86. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  99 

our   further  consideration  of  these  dangerous  elements  of   social 
heredity.* 

Under  the  third  division,  worry,  is  usually  classed  the  various 
neurasthenic  and  psychasthenic  manifestations  whose  principal 
origin  is  in  mental  shocks  and  morbid  fancies  that  lead  to  drug 
addiction;  the  typical  forms  of  hysteria:  and  the  psycho-neuroses 
generally.  Increasing  responsibility  and  the  strains  of  the  social 
environment  in  modern  high  pressure  civilization  lay  heavy  bur- 
dens on  the  nervous  system  of  man  and  the  minor  defects  that 
pass  -unnoticed  in  the  less  strenuous  social  surroundings  appear 
here  in  numerous  slight  or  serious  disorders  of  the  psychic  life. 
The  sick  headache,  the  overpowering  anxiety,  the  fixed  idea,  the 
various  fears  that  burden  the  unhappy  mind  are  but  a  few  of  the 
forms  that  define  the  mind's  unhealthy  condition. 

For  further  discussion  we  must  refer  the  reader  to  the  texts  on 
mental  disease  enumerated  in  the  bibliography  at  the  close  of  this 
article. 

PREVALENCE  OF  INSANITY. 

Not  all  of  the  types  mentioned  above  find  their  way  into  public 
or  even  private  hospitals  for  mental  disease.  Our  data  must, 
therefore,  be  based  largely  upon  the  number  of  cases  that  come  to 
the  hospitals  for  treatment  and  care.  In  the  United  States  in 
1910,  there  were  187,151  people  in  hospitals  for  the  insane.  On 
the  basis  of  statistics  in  other  countries  and  those  available  in 
the  United  States,  there  must  be  at  least  250,000  people  in  this 
country  who  are  insane.  In  1901,  it  was  estimated  that  the  cost 
of  caring  for  the  insane  and  feeble-minded  amounted  to  sixty  mil- 
lion dollars  a  year,  and  the  additional  loss  in  industrial  activity 
was  at  least  twenty  millions  more. 

In  Texas  in  1910,  there  were  4053  people  in  these  hospitals  for 
the  insane,  or  one  person  in  961  of  the  total  population  was  shut 
up  in  an  insane  hospital.  In  1911,  this  year,  the  estimates,  in- 
cluding those  in  private  sanitaria  and  in  county  jails  and  poor 
farms,  reach  a  total  of  over  5500.  These  are  the  known  insane 
in  Texas — how  many  others  are  in  need  of  treatment  and  care 
no  one  can  safely  estimate.     The  most  conservative  estimates  place 

*Cf.  Mitchell,  H.  W.,  in  W.  &  J.,  op.  cit.,  v.  1,  article  on  Alcoholism  and 
the  Alcoholic  Psychoses. 


100  Bulletin  of  the  University  of  Texas 

the  ratio  of  insane  to  the  total  population  at  one  in  every  500. 
Dr.  Thomas  TV.  Salman,  of  the  National  Committee  for  Mental 
Hygiene,  estimates  "that,  after  having  made  allowance  for  all 
factors  (age  periods,  proportion  of  foreign-born  population,  etc.), 
many  of  which  are  not  easily  determinable,  the  number  of  the 
insane  in  institutions  in  Texas  would  be  very  unlikely  to  exceed 
60  per  cent  of  the  entire  number  for  whom  provision  should  be 
made."*  This  would  give  Texas  a  total  insane  population  of 
about  9166  based  on  the  data  above.  In  countries  where  these 
ratios  are  carefully  worked  out  "the  ratio  of  the  number  under 
treatment  to  the  population  is  about  495  per  100,000  in  cities  and 
247  per  100,000  in  rural  communities." f  This  ratio  would  give 
Texas  a  total  of  12,162  in  the  State  in  1910. 

Lewellys  F.  Barker  of  Johns  Hopkins,  in  an  article  entitled 
"Unsoundness  of  Mind,  a  National  Handicap,"  says : 

"Unsoundness  of 'mind  in  its  various  forms  is  alarmingly  prev- 
alent in  this  and  in  all  civilized  countries.  It  is  veritably  a  heavy 
burden  borne  by  every  nation.  Its  occurrence  can  be  and  should 
be  diminished.  There  are  difficulties  in  the  way,  but  they  must 
be  overcome.  For  the  present  we  can  do  most  by  stimulating  in- 
vestigation and  by  educating  the  public  regarding  well  established 
facts.  Surely  the  work  is  wide  and  noble  in  its  purpose.  It  is 
worthy,  surely,  of  the  devotion  and  enthusiasm  of  our  most  patri- 
otic citizens.  In  such  a  work  they  can  find  ample  opportunity 
for  the  exercise  of  their  highest  faculties." J 

STATE  POLICY  BESPECTING  THE  INSANE. 

The  care  and  protection  of  the  insane  is  perhaps  developed  more 
than  the  care  of  any  other  of  the  unfortunate  classes.  State  and 
government  have  found  it  necessary  to  place  these  persons  in  cus- 
tody from  early  times.  The  care  that  has  been  given  the  insane 
has  not  always  been  of  the  best;  it  has  too  long  been  thought 
sufficient  to  put  them  out  of  reach  of  society  or  merely  to  protect 
society  from  them  if  dangerous. 

Throughout   history,   however,   many  of  the   insane   have  gone 

*Letter  to  R.  J.  Newton,  Public  Health  Association,  Austin,  Texas. 

tOp.   cit. 

$  Report    of   Mental    Hygiene   Congress,   p.    11. 


Cure  of  the  Feeble-minded  and  Insane  in  Texas  10 J 

without  that  protection  that  is  their  due  or  have  been  menaces  to 
the  rest  of  society.  In  many  instances  we  are  still  far  less  careful 
of  our  dangerous  insane  than  we  are  of  other  and  better  known 
forms  of  disease.  Daily  reports  of  the  ravages  of  this  class  upon 
unsuspecting  citizens  are  common.  The  list  of  men  prominent  in 
public  affairs  killed  and  injured  by  these  mentally  disordered  is 
a  long  one.  "Gyp  the  Blood"  of  recent  notoriety  was  declared  by 
the  court  the  first  time  he  was  arrested  for  burglary,  to  be  "morally 
irresponsible."  A  defective  shot  Roosevelt,  another  killed  McKin- 
ley,  another  Mayor  Gaynor,  and  the  list  still  grows. 

The  laissez  faire  policy  of  the  public  toward  the  harmless  insane 
and  the  mental  defective  produces  the  great  majority  of  crimes 
against  persons,  arsons,  thefts,  and  the  large  body  of  "cranks"  and 
members  of  freak  societies  that  abound  in  our  urban  centers.  It 
will  doubtless  always  be  the  work  of  our  social  agencies  to  discover 
these  socially  unfit  and  inform  the  proper  authorities  of  their 
presence  in  the  community.  Such  work  will,  however,  be  largely 
futile  and  wasted  if  the  State  does  not  supply  the  proper  means 
for  their  custodial  care  and,  in  the  case  of  the  insane,  provide  for 
their  proper  treatment  as  soon  as  discovered. 

The  first  function  of  the  State  in  connection  with  the  insane 
when  it  took  authority  over  them  at  all  was  custodial.  They  were 
treated  in  all  respects  as  criminals  and  incarcerated  in  prisons  and 
fastened  with  chains,  or  tortured  to  reveal  the  source  of  their 
supernatural  power.  While  this  function  must  still  be  exercised 
by  the  State,  we  no  longer  do  so  because  of  any  ideas  that  we  are 
thereby  punishing  them  for  wrongdoing.  In  1792,  Pinel  first 
induced  the  authorities  to  remove  the  chains  from  the  insane  in 
the  large  hospitals  of  Paris.  From  this  time  the  treatment  of  the 
mentally  diseased  has  slowly  improved  and  medical  and  psycho- 
logical science  is  now  showing  that  these  diseases  are  the  ordinary 
"devils"  of  ill-health  and  bad  habits. 

Because  of  the  nature  of  many  mental  diseases  the  person  suf- 
fering from  them  is  dangerous  to  society.  He  is  obsessed  with 
the  idea  that  he  must  kill  someone;  he  is  sure  that  some  high 
authority  has  told  him  to  destroy  his  own  life;  persons  are  per- 
secuting him  and  the  only  way  to  save  himself  is  to  kill  them  or 
they  will  kill  him;  or  he  must  save  his  country  from  some  wicked 


102  Bulletin  of  the  University  of  Texas 

tyrant.  The  killing  of  entire  families  by  one  of  its  members,  the 
horrible  butchery  of  some  innocent  child  or  woman,  the  burning 
of  the  home,  the  disappearance  of  some  member  of  the  family,  the 
theft  stories  often  told  in  the  newspapers,  are  terrible,  each  a  crime 
that  concerns  the  welfare  of  the  State  and  the  safety  of  its  citizens. 

As  a  result  of  this  condition,  in  earlier  times  all  the  insane  were 
treated  as  though  this  was  their  character  and  sent  to  prison.  Even 
in  modern  times  this  feeling  of  terror  in  the  presence  of  an  insane 
person  has  not  fully  abated.  We  find  the  average  person  shrink- 
ing from  their  presence  and  dreading  the  mentally  diseased  with 
a  dread  that  is  not  wholly  that  of  one  in  the  presence  of  the  strange 
and  unusual.  In  California,  at  one  of  the  asylums,  a  woman  was 
brought  in  wrapped  up  in  a  bed  tick  that  was  bound  tightly  about 
with  over  one  hundred  feet  of  rope.  When  released  the  little 
woman  arose  to  go  with  the  attendant,  trembling  with  fear  from 
the  rough  usage  she  had  endured.  It  is  not  an  uncommon  sight  to 
see  two  or  three  men  come  as  attendants  with  a  patient  who  is 
himself  shrinking  and  trembling  with  fear  or  shame.  It  is,  how- 
ever, only  after  study  and  long  observation  that  the  expert  can 
detect  the  dangerous  insane  in  some  cases.  These  are,  moreover, 
but  a  small  portion  of  those  who  are  mentally  sick  and  in  need 
of  treatment.  All  patients  are  under  all  conditions  when  properly 
treated  taken  to  hospitals  for  the  insane  and  there  given  proper 
medical  care  until  their  status  is  determined.  In  some  States  the 
criminal  insane,  those  who  after  the  commission  of  a  crime  and 
trial  are  declared  insane,  are  sent  to  special  hospitals.  New  York 
has  two  such  hospitals.  This  classification  may  or  may  not  be 
possible  in  smaller  States.  It  is,  however,  wise  to  have  special 
wards,  so  that  the  classification  of  the  patients  may  be  made  more 
or  less  complete  and  each  type  of  disease  receive  its  proper  treat- 
ment. The  criminal  or  suicide  may  thus  properly  be  kept  in  wards 
apart  from  the  other  patients.  This  custodial  duty  with  reference 
to  the  insane  clearly  belongs  to  the  State. 

The  insane  are  not  only  in  need  of  the  custodial  care  of  the 
State,  but  authority'  of  one  sort  or  another  must  protect  the  prop- 
erty rights  of  the  individual  and  the  very  individual  himself.  We 
have  publicly  assumed  the  hospital  care  of  the  homeless  sick.  The 
police  station  is  but  a  short  step  on  the  way  to  the  hospital  for 


Care  of  the  Feeble-minded  and  Insane  in  Texas  103 


Asylum  Careys.  Hospital  Treatment 


Vnsane  department"  of  a  county  almshouse 


Day -room  in,  a  modern  State  -Jwspifat. 

Plate  XX. 

Handbook    of   the    Mental    Hygiene    Movement   and    Exhibit,    New   York, 

"Chart  No.  28. 


104  Bulletin  of  the  University  of  Texas 

many  an  unfortunate,  and  soon  it  should  become  the  same  short 
step  for  the  insane.  The  city  ambulance  some  day  will  carry  the 
insane  directly  to  the  mental  hospital  in  all  our  larger  cities  instead 
of  to  the  police  station  and  then  to  jail.  It  is  done  today  in  Boston 
and  New  York.  His  property  cannot  be  touched,  or  his  person 
harmed,  nor  can  any  change  he  made  in  his  status  as  a  citizen 
while  he  is  under  this  hospital  care.  When  he  is  found  to  be  per- 
manently disabled  or  the  time  or  the  course  of  the  disease  is  un- 
known, the  simple  methods  of  procedure  already  prepared  by  law 
are  sufficient.  There  have  been  but  few  exceptions  to 'the  belief 
that  the  State  should  take  this  custodial  and  protective  attitude 
toward  the  insane.  Their  danger  to  society,  the  expensive  nature 
of  the  care  that  must  be  provided,  the  necessity  for  safeguarding 
the  personal  and  property  rights  of  the  individual,  the  lasting 
nature  of  their  disease  in  many  instances,  all  combine  to  make 
family  care  impossible  except  in  special  instances  and  in  most 
communities  operate  to  make  local  care  unsuitable  and  highly 
expensive. 

The  neuropathic  constitution  and  its  attendant  mental  disorders 
are  primarily  due  to  inheritance.  This  consideration  makes  it  highly 
desirable  that  authorities  sufficiently  powerful  to  enforce  their 
mandates  exercise  control  over  the  manifest  sigus  of  such  defective 
strains.  This  problem,  the  problem  of  prevention,  has  not  been 
attacked  with  any  widespread  vigor  yet.  Continuous  custodial 
care,  proper  marriage  regulation  for  the  insane,  and  the  various 
means  of  prevention  are  still  ■  playthings  for  the  ignorant  and 
jokes  to  the  credulous.  Only  as  the  State  seriously  undertakes  to 
free  its  citizenship  of  the  defective  strains  by  proper  means  can 
we  hope  to  educate  the  whole  population  concerning  the  laws  of 
inheritance  and  develop  a  vigorous  aversion  to  the  defective  strains 
in  people.  Till  that  point  is  reached  the  State  must  exercise  con- 
straint over  these  various  disorders  in  the  same  way  that  we 
recognize  its  necessity  for  the  feeble-minded  and  criminal. 

The  third  problem  in  connection  with  the  insane  that  the  State 
is  undertaking  to  supply  an  answer  for  is  the  proper  medical  treat- 
ment of  these  disorders  when  it  is  needed  and  as  long  as  it  is 
needed.  The  correct  methods  of  treatment  for  mental  disorders 
are  perhaps  the  most  expensive  that  medicine  affords  when  carried 


Care  of  the  Feeble-minded  and  Insane  in  Texas  105 

out  properly.  This  is  not  because  of  the  need  for  the  expert  in 
mental  diseases  alone;  the  whole  man  is  diseased  in  mental  dis- 
ease, and  all  forms  of  medical  ion,  of  social  study  and  moral  sup- 
port must  come  to  the  aid  of  the  physician  in  the  effort  to  read- 
just the  patient  to  his  environment.  This  special  treatment  de- 
mands the  best  type  of  hospital  with  the  most  modern  appliances 
and  skill  in  all  branches  of  medicine.  Mental  diseases  are  the 
latest  to  come  under  the  careful  eye  of  the  scientist,  and  at  the 
present  time  the  hospital  thus  furnished  and  maintained  by  the 
State  will  also  afford  the  very  best  agency  in  the  further  study  of 
the  many  problems  connected  with  mental  disorder.  Such  hos- 
pitals also  afford  the  finest  aids  to  medical  instruction  in  their 
clinical  wards. 

The  haphazard  policy  of  the  State  is  sustained  by  the  theory 
that  those  who  are  Aveakest  and  most  unfit  for  life  will  be  elim- 
inated by  processes  of  natural  selection  and  the  survival  of  the 
fittest.  Statistics  show  that  this  is  not  true  in  civilized  commu- 
nities. Charity  and  humanitarian  interests  work  in  opposition  to 
these  primitive  laws.  The  forces  of  civilization  as  well  as  its 
vices  tend  to  increase  the  number  of  unfit  that  are  born  into 
society,  and  are  aided  in  maintaining  a  precarious  foothold  on  the 
lower  edge  of  humanity.  We  have  by  no  means  reached  the  end 
of  such  a  policy.  Changing  ideas  with  reference  to  the  place  of 
mental  disease  as  well  as  that  of  other  diseases  are  appearing  slowly, 
ideas  of  the  laws  of  heredity  and  their  operation  are  becoming 
more  and  more  prevalent.  More  and  more  are  marriages  and 
failures  to  marry  based  on  the  knowledge  of  physical  and  mental 
defects  in  the  famiiy  strains.  This  slow  progression  is  evidently 
not  keeping  pace  with  the  forces  operating  in  the  opposite  direc- 
tion. Certainly  the  older  communities  and  the  European  coun- 
tries show  a  larger  population  of  feeble-minded  and  insane  than 
this  country,  and  Texas  undoubtedly  has  a  smaller  percentage  of 
both  classes  than  States  like  New  York  and  Massachusetts. 

Placing  the  insane  in  jails  and  on  poor  farms  and  in  our  prisons 
is  primarily  for  the  safety  of  the  State,  and,  secondarily,  a  simple 
and  expeditious  means  of  getting  these  suffering  and  diseased 
people  out  of  sight.  It  also  operates,  unintentionally,  however,  in 
the   prevention    of  a  still   larger  increase  of  these  socially  unfit. 


106 


Bulletin  of  the  University  of  Texas 


© 

6 

M         ft 

■<5         CD 
^         si 


Care  of  the  Feeble-minded  and  Insane  in  Texas  107 

The  right  to  be  well  born  is  a  consideration  that  works  in  the  case 
of  parents  almost  in  inverse  proportion  to  the  nerd  for  the  oper- 
ation of  such  an  ideal.  The  weakling  and  mentally  enfeebled  re- 
sponds to  impulse  and  the  animal  instincts  without  reflection. 
Nor  has  the  State  as  yet  any  principle  of  prevention  in  operation 
beyond  these  accidental  effects  of  the  necessity  for  custodial  care 
and  imprisonment.  It  is  highly  essential  that  our  legislators  and 
State  and  national  authorities  realize  that  prevention  is  the  only 
means  that  will  offer  a  satisfactory  solution  to  this  problem. 

Finally  the  State  must  realize  more  fully  that  upon  it  devolves 
the  duty  of  caring  for  and  curing  where  possible  all  those  whose 
diseases  and  defective  conditions  are  due  to  the  ignorance,  evil, 
and  unfitness  of  its  members.  It  can  no  longtr  merely  punish 
the  individual  and  leave  the  condition  that  produced  that  individ- 
ual go  unremedied.  Whether  it  be  through  poor  educational  sys- 
tems, through  neglect  of  the  laws  of  health  and  sanitation,  through 
disregard  of  the  biological  laws  of  inheritance,  or  through  the 
failure  to  provide  against  unnatural  conditions  of  labor,  the  citi- 
zens of  the  State  are  jointly  and  severally  and  through  their  prop- 
erly constituted  authorities  responsible  for  the  sort  of  life  that 
comes  into  the  world  and  its  protection  and  development  during 
its  progress  through  the  world. 

CONDITIONS  IN  TEXAS. 

Generalizations  are  not  always  convincing  or  even  interesting. 
Texas  has  three  asylums  or  hospitals  for  the  insane.  One  of 
these,  the  oldest,  is  located  at  Austin  and  is  still  called  the  State 
Lunatic  Asylum, — a  reminder  of  ancient  days.  The  other  two 
are  located  at  Terrell  and  San  Antonio.  The  institution  at  Austin 
was  established  in  1857,  in  1860  it  contained  only  sixty  patients. 
In  1912  it  had  a  capacity  of  1600  patients  and  was  filled  to  capac- 
ity. In  1885,  the  North  Texas  Hospital  for  the  Insane  was  opened 
at  Terrell.  In  1912,  it  accommodated  2225  patients.  In  1892, 
the  Southwestern  Asylum  for  the  Insane  was  opened ;  it  now  pro- 
vides for  1140  patients.  The  total  property  valuation  of  these 
three  institutions  is  $2,000,000.  At  Abilene  there  is  a  colony  for 
epileptics  with  474  patients  and  a  property  valuation  of  $350,000. 


108  Bulletin  of  the  University  of  Texas 

In  these  four  institutions,  in  1912,  there  were  confined  5139  per- 
sons.* 

The  amount  of  money  spent  annually  is  over  $700,000.  This 
amount  is  actual  running  expenses  and  does  not  take  account  of 
the  necessary  additions  to  the  buildings  and  grounds.  What  does 
the  State  get  for  this  sum  of  money?  First,  it  gets  insufficient 
care  and  incomplete  treatment  for  those  it  has  undertaken  to  put 
into  these  institutions.  Second,  because  of  the  crowded  conditions, 
large  numbers  that  its  courts  have  already  said  should  be  in  these 
institutions  are  kept  out.  And,  third,  its  short-sighted  policy  con- 
cerning prevention  and  regulation  is  allowing  the  cost  of  these 
institutions  to  increase  rapidly  from  year  to  year. 

The  conditions  above  described  leave  the  State  in  ignorance  con- 
cerning the  unhealthy  conditions  that  are  producing  the  increase 
in  the  insane  and  epileptic.  Doubtless  the  superintendents  of  these 
institutions  are  learning  many  valuable  things  about  these  various 
danger  spots  in  our  State,  but  we  crowd  them  with  work  and 
numerous  minor  duties  till  they  have  no  time  to  record  their 
impressions  and  data.  We  allow  them  no  officers  to  collect  such 
information  and  publish  it.  The  mine  of  information  that  lies 
in  the  histories  of  the  cases  that  have  passed  through  the  hospitals 
would,  if  arranged  and  studied,  give  us  valuable  information  about 
what  Ave  may  expect  to  happen  in  the  future  as  the  State  increases 
in  density  of  population.  The  insufficient  number  of  physicians 
prevent  complete  study  of  cases  and  detailed  classification  as  well 
as  adequate  treatment  of  those  in  the  institutions.  The  psychol- 
ogist is  not  yet  even  recognized  as  essential  to  the  staff  of  our 
asylums  in  Texas. 

We  have  provided  out  of  the  funds  of  the  State  of  Texas  the 
institutions  above  described  to  keep  the  mentally  sick  away  from 
the  public  and  in  a  place  where  he  will  have  some  chance  of  get- 
ting well,  or  where  he  can  live  his  life  in  comparative  health  and 
comfort  and  be  treated  for  his  disease.  We  have  seen  that  this 
is  not  adequately  done  by  the  State  of  Texas.  We  have  not  even 
supplied  places  for  all  that  ask  us  for  help.  There  are  at  present 
471  insane  persons  in  the  county  jails  and  on  the  poor  farms  of 
the  State,  or  at  home  adjudged  insane  waiting  for  a  place  to  be 

*Twenty-first  Annual  Eeport  of  the  Southwestern  Insane  Asylum  for 
the  year  ending  August  31,   1912,  pp.  8-9. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  L09 

given  them  in  our  State  institutions.  What  is  their  condition 
while  waiting?  One  man  in  West  Texas  was  forced  to  build  a 
separate  house  for  his  insane  wife  and  kept  her  on  the  place. 

The  writer  has  actually  visited  practically  all  the  counties  men- 
tioned in  the  following  pages.  He  found  the  county  officials 
everywhere  willing  to  assist  him  in  the  investigation  and  univer- 
sally expressing  the  feeling  that  such  conditions  ought  not  exist. 
As  far  as  the  insane  in  the  jails  are  concerned,  they  express  them- 
selves as  powerless  to  act.  They  are  not  ahle  to  get  them  to  the 
asylums  and  must  keep  them  somewhere.  The  situation  of  the 
idiots  and  the  feeble-minded  is  also  beyond  their  control.  All  feel 
vaguely  that  where  these  persons  are  kept  is  not  the  right  place 
for  them,  but  they  have  little  knowledge  concerning  the  solution 
of  the  problem.  Where  an  official  is  aware  of  the  need  for  train- 
ing these  unfortunates  he  declares  that  he  has  not  the  time,  and 
plainly  has  not  the  ability  to  do  this.  The  results  of  this  inade- 
quate State  policy  and  of  the  neglect  of  county  officials  to  do  what 
is  in  their  power  to  better  the  local  buildings  and  sanitary  condi- 
tions, cannot  be  said  in  words  alone.  Texas  need  not  pride  her- 
self on  being  the  greatest  State  in  the  Union  so  long  as  she  harbors 
in  every  county  in  the  State  such  conditions  as  are  barely  touched 
in  the  descriptions  given  below. 

Bell  County. — In  this  jail  there  were  three  insane  at  the  time 
it  was  visited.  One  was  allowed  the  freedom  of  the  streets  during 
the  daytime  and  one  was  soon  to  be  sent  home  till  a  place  could 
be  found  at  the  State  asylum.  The  third,  a  negro  woman,  had 
been  in  the  jail  for  a  year.  She  was  kept  in  the  basement  and 
refused  to  wear  any  clothing  or  even  to  keep  a  blanket  in  the  cell. 
When  seen  she  was  lying  on  her  back  on  the  cement  pavement  in 
semi-darkness.  Upstairs  with  the  other  prisoners  was  a  young 
man  of  possibly  twenty-five,  who  was  probably  feeble-minded  as 
well  as  insane.  He  is  very  docile  and  capable  of  doing  a  great 
deal  of  work  under  proper  direction,  but  addicted  to  "such  prac- 
tices that  if  left  in  this  condition  will  soon  become  an  imbecile 
and  physical  wreck.  His  place  is  on  a  farm  where  he  will  have 
regular  and  continuous  exercise  and  intelligent  supervision  the 
remainder  of  his  life.  His  brother  had  been  in  the  Austin  asylum 
and  the  father  and  three  other  children  are  reported  feeble-minded. 


no 


Bulletin  of  the  University  of  Texas 


and  totally  lacking  in  self-control.  The  mother  has  been  hys- 
terical and  insane  at  various  times  but  has  never  been  committed. 
At  the  poor  farm  were  three  distinctly  insane  persons.  One  old 
woman  made  life  a  burden  for  all  the  others  by  her  desire  to  steal 
evervthing  she  could  find  and  bide  it  in  her  trunk.     Just  before 


Plate  XXII. 

The  basement  room  in  which  this  insane  negro  woman 
has  lived  for  over  a  year  was  so  dark  that  it  required 
80  seconds  to  get  this  picture.  She  is  a  maniac;  re- 
fuses to  wear  her  clothing  or  to  keep  bedding  in  the 
cell.     Proper  care  and  treatment  would  change  all  this. 


my  arrival  a  man  had  barely  failed  in  an  apparent  attempt  at 
suicide  by  cutting  his  wrist  with  a  razor.  A  third  has  frequent 
epileptic  fits.  The  cottages  at  the  poor  house  are  woefully  over- 
crowded. 

Bexar  County. — This  county  has  an  excellent  jail  building,  but 


Care  of  the  Feeble-minded  and  Insane  in  Texas  111 


112  Bulletin  of  the   University  of  Texas 

sanitary  conditions  are  very  poor.  The  floors  cannot  be  flushed 
and  the  two  wards  where  the  insane  are  kept  are  in  wretched  con- 
dition. June  11  there  were  nine  insane  in  these  quarters.  One 
negro  woman  had  been  in  her  cell  for  considerably  over  a  year. 
A  white  woman  in  the  maniacal  stage  tore  her  clothing  continual^, 
and  the  man  whose  picture  is  shown  above  is  kept  in  this  way  to 
save  his  clothing,  possibly  (?).  The  man  seen  through  the  bars 
at  the  left  of  the  picture  has  been  in  jail  for  several  months,  but 
is  now  in  such  a  condition  of  health  that  his  relatives  are  attempt- 
ing to  remove  him.  Both  he  and  the  negro  woman  are  compelled 
to  listen  to  the  ravings  of  the  man  in  the  foreground  day  and  night. 

In  the  first  picture*  is  shown  the  regular  ward  to  which  all  male 
insane  are  assigned;  as  many  as  fifteen  have  been  kept  in  this 
"monkey  cage"  for  weeks.  It  is  approximately  21x24  feet  in  size 
and  so  dark  that  a  flash  light  was  necessary  to  obtain  the  above 
pictures.  All  cells  have  cement  floors  and  the  three  that  held  the 
negress  and  two  men  mentioned  above  were  partioned  off  on  three 
sides  by  solid  steel  walls.  One  of  these  was  so  dark  that  the  back 
wall  could  not  be  seen  and  contained  absolutely  nothing  but  the 
naked  insane  patient — no  bedding,  chairs,  no  matting  of  any  sort 
was  to  be  seen.     In  this  picture  the  man  is  listening  to  "voices." 

At  the  poor  farm,  under  the  charge  of  one  untrained  woman 
were  found  twenty-two  women — insane,  senile,  and  idiotic.  Xot 
one  of  them  was  capable  of  adequately  caring  for  herself.  The 
wards  here  are  floored  with  rough  boards,  showing  broken  places 
and  impossible  of  sanitary  cleansing.  Two  idiotic  children  sat  on 
an  upper  gallery  covered  with  filth  and  flies.  Two  "dope"  fiends 
lav  on  their  beds  below  in  similar  or  worse  condition.  In  the 
wards,  on  the  galleries,  and  out  under  the  trees,  killing  time  by 
months  and  years,  sat  or  lay  one  hundred  others  from  an  idiotic 
boy,  who  climbed  trees  only  to  fall  out,  breaking  the  branches  of 
the  trees  about  the  yard,  to  infirm  old  men  and  women  who  could 
only  lie  on  their  beds  and  moan.f  The  superintendent  reported 
]20  at  the  poorhouse  the  day  we  visited  it. 

Fortunately  for  the  reputation  of  Bexar  county,  plans  are  on 
foot  to  build  a  modern  building  on  a  large  farm  south  of  town, 

*See  p.   HO.  plate  XXII:   p.   Ill,  plate  XXIII. 
fSee  plate  X,   p.   48. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  113 

where  the  inmates  will  be  given  greater  freedom  and  be  put  to 
work  as  far  as  they  are  able.  A  change  in  the  situation  cannot 
come  too  soon.  It  has  not  vet  been  conceded  that  dirt  and  filth 
are  •necessary  adjuncts  to  poverty  and  old  age;  especially  is  this 
to  be  deplored  where  the  people  of  a  rich  and  populous  country 
are  pretending  to  care  for  these  people.  1  have  tempered  the 
description  of  these  poor  farms  and  jails  far  too  much,  1  fear,  to 


Plate  XXIV. 
Collin   County  Insane. 

suit  the  real  situation.  Anyone  who  will  take  a  half  hour  and 
make  the  trip  to  their  poorhouse  or  farm  can  see  that  the  above  is 
a  pleasant  picture  beside  the  one  that  actually  greets  his  eye. 

Collin  County. — All  the  insane  not  sent  to  the  asylums  are  sent 
to  the  county  farm.  There  were  four  at  the  farm.  One  man, 
R.  W.,  stayed  in  jail  seven  months  before  he  was  sent  out  to  the 
farm.     One  woman,  very  troublesome,  had  been  at  the  farm  a  year. 


114  Bulletin  of  the  University  of  Texas 

She  has  four  children,  three  by  her  first  husband  and  one  by  the 
second.  All  of  the  children  are  below  grade  mentally;  three  were 
at  orphans'  homes. 

Both  of  the  persons  photographed  on  Plate  XXIV  are  at  the 
poor  farm.     Neither  receive  treatment  or  expert  care. 

Dallas  County. — There  were  fifteen  in  jail  when  visited.  This 
is  about  an  average  number.  Whenever  it  is  at  all  possible,  the 
county  judge  humanely  releases  the  insane  on  bond  till  they  can 
find  a  refuge  in  the  State  institutions.  About  an  equal  number 
were  at  this  time  being  cared  for  this  way.  The  present  jail 
is  as  bad  as  the  one  at  San  Antonio  or  at  Fort  Worth.  (Dallas 
county  is,  however,  building  a  modern  jail  that  will  provide  as 
comfortable  quarters  for  the  insane  as  is  possible  in  a  jail.)  One 
poor  man  insane  and  sick  physically  as  well,  was  confined  in  a 
narrow  solitary  cell;  his  bed  consisting  of  a  mattress  and  a  blanket, 
was  on  the  floor.  A  miserable  condition  for  a  man  doubly  sick  to 
spend  weeks  and  months  in. 

The  poor  farm,  except  for  its  antiquated  buildings,  was  kept 
clean  and  wholesome.  Here  the  writer  found  the  first  hospital 
building  on  a  poor  farm.  It  contained  five  beds,  all  full,  and  was 
well  equipped  for  its  simple  purposes.  The  idiots  found  here  were 
of  the  very  lowest  grade.* 

In  the  city,  as  in  Fort  Worth  and  elsewhere,  reports  of  num- 
bers of  feeble-minded  making  monthly  calls  for  help  came 
from  the  Associated  Charities.  The  office  stated  that  they  had 
dealt  with  101:  cases  of  feeble-minded  within  the  last  year.  One 
woman  discharged  from  the  asylum  at  Terrell  had  had  four  chil- 
dren since  her  discharge.  She  was  hot  married.  All  of  these  chil- 
dren are  charity  charges.  Another  family,  consisting  of  a  father 
and  six  children,  was  inadequately  cared  for  by  a  feeble-minded 
relative.  The  whole  family  was  decidedly  feeble-minded.  The 
mother  died  insane. 

The  Virginia  K.  Johnson  Home  for  erring  girls  reported  through 
their  resident  physician  that  over  30  per  cent  of  the  girls  that 
came  to  them  were  feeble-minded,  and  at  least  60  per  cent  more 
were  marked  as  "stunted/'  f 

•See    plate    X,    p.    48. 

tThis  home  is  an  interesting  case  of  a  good  impulse  poorly  carried  out. 
Inadequate  support  and  an  incomplete  understanding  of  the  correct  treat- 


Care  of  I  he  Feeble-minded  and  Insane  in  Texas  115 

The  Dallas  News  of  February  23,  1014,  also  tells  us  bow  Dallas 
county  takes  care  of  her  insane  while  waiting  for  the  State  to  take 
them  : 

"After  having  taken  steps  to  make  provision  for  proper  care  of 
wards  of  the  county  either  awaiting  trial  for  insanity  or  already 
adjudged  insane,  the  county  commissioners  court  lias  abandoned 
the  plan  and  decided  to  continue,  as  in  the  past,  leaving  such  cases 
in  the  county  jail  or  in  care  of  friends  or  relatives  who  were  will- 
ing to  incur  sacrifices,  no  matter  how  great,  rather  than   permit 

their  loved  ones  to  he  placed  in  the  jail.     The  condition  lias  ! n 

particularly  aggravated  within  the  last  week  by  an  outbreak  of 
smallpox  in  the  county  jail,  and  several  instances  have  come  to 
light  showing  the  grave  possibilities  and  results  of  inadequate  pro- 
visions for  such  cases,  to  say  nothing  of  numerous  other  cases  of 
drug  addictions  that  the  county  has  on  its  -hands. 

"At  the  present  time  and  for  the  greater  part  of  the  time  for  two 
or  three  }rears,  the  county  has  had  constantly  in  the  county  jail 
from  five  to  twelve  or  more  men  and  women,  either  already  ad- 
judged insane  or  awaiting  trial.  Within  the  last  year  or  two  years 
the  number  of  drug  addicts  in  the  county  has  also  increased  alarm- 
ingly and  the  county  at  all  times  has  in  the  jail  a  large  number 
of  such  unfortunates,  mostly  women. 

"The  continually  crowded  condition  of  the  three  State  Insane  Asy- 
lums has  made  it  practically  impossible  within  recent  years  to 
obtain  immediate  admission  to  an  asylum  for  any  patient  just 
adjudged  insane,  and  that  is  the  primary  reason  that  the  county 
has  to  take  care  of  so  many  insanity  cases  for  periods  of  from 
three  to  six  or  nine  months,  until  they  can  be  admitted  to  an 
insane  asylum.  The  question  has  been  raised  by  physicians  and 
others  as  to  whether  this  necessity  for  holding  such  patients  im- 
poses upon  the  county  any  duty  to  provide  treatment  and  a  dif- 
ferent kind  of  care  for  them  from  what  is  ordinarily  given  to 
inmates  of  the  county  jail  confined  upon  criminal  charges.  The 
county   commissioners,   at  least   by  inference,   admitted  that  'this 

ment  to  be  accorded  such  girls  allow  these  delinquents  easily  to  return  to 
their  former  lives.  No  responsibility  for  their  children  or  for  their  own 
support  while  in  the  institution  and  no  adequate  training  for  the  future 
leave  the  girls  at  the  end  of  the  two  years  much  in  the  same  condition  it 
found  them.  Average  age  of  these  girls  last  year  was  17;  extreme  range 
22  and  12. 


116  Bulletin  of  the  University  of  Texas 

was  a  duty  when  they  began  plans  for  the  county  insane  hospital; 
now,  for  reasons  of  economy,  they  have  rescinded  the  former  order. 

^pa&^^<wS  NO    TREATMENT    POSSIBLE. 

"The  county's  problem  in  caring  for  insanity  cases  is  greatly 
complicated  by  the  fact  that  it  has  had  up  to  the  present  time  no 
place  except  the  county  jail  in  which  to  confine  them.  The  old 
county  jail,  built  more  than  thirty  years  ago,  contained  no  sep- 
arate cells  for  such  cases,  and  it  has  not  at  the  present  time  any 
provision  for  giving  the  patients  even  a  different  kind  of  fare  from 
the  ordinary  prison  fare.  Such  matters  as  fare  and  cells  can  prob- 
ably be  corrected  in  the  new  jail. 

"An  example  of  the  difficulty  that  is  encountered  by  county 
officials  in  the  matter  of  securing  admission  to  the  State  Insane 
Asylum  is  to  be  found  in  the  case  of  a  woman  who  was  violently 
insane  and  held  in  an  ordinary  cell  at  the  county  jail  several  weeks 
ago.  The  case  attracted  widespread  attention  and  finally  the 
grand  jury  investigated.  The  foreman  of  the  grand  jury,  Sam  P. 
Cochran,  consulted  with  a  former  State  Senator,  and  their  com- 
bined efforts  resulted  in  a  place  being  made  for  her  at  Terrell. 
She  Avas  transferred  within  two  weeks  after  having  been  adjudged 
insane.  In  cases  where  no  special  influence  is  brought  to  bear,  the 
amount  of  time  the  patient  may  languish  in  the  county  jail  with- 
out treatment  varies  greatly. 

"The  county  is  spending  more  than  $600,000  upon  the  new  jail 
and  criminal  courts  building.  The  jail  portion  of  the  building 
will  probably  represent  two-thirds  of  that'  expense  and  will  have  a 
capacity  of  250  prisoners.  The  county  is  spending  on  a  building 
for  its  prisoners  charged  with  crime  an  average  of  $1500  per  pris- 
oner, yet  the  county  refused  to  expend  upon  a  building  for  its 
insane  prisoners,  that  would  have  offered  opportunities  for  proper 
treatment,  an  average  of  not  to  exceed  $500  per  prisoner,  esti- 
mated from  a  standpoint  of  capacity. 

That  conditions  in  Dallas  county  are  bad  is  admitted  on  all 
sides,  and  first  of  all  by  the  county  officials.  County  Judge  Corley 
yesterday  said  that  he  had  upon  his  insane  docket  probably  ten 
or  twelve  cases  already  declared  insane,  yet  no  places  can  be  found 
for  them  in  the  asylums. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  11? 

"'What  have  you  done  with  them?5  he  was  asked. 

"  'Some  of  them  are  in  the  county  jail  now,  possibly  six  or  eight/ 
he  replied. 

"  'And  where  are  the  others  ?' 

"'Well,  I  don't  mind  admitting  that  I  probably  violated  the  law 
in  doing  it,  but  1  let  their  people  take  them  home  to  take  care  of 
them.  And  I  did  it  from  a  humanitarian  standpoint,  because 
Dallas  county  has  no  fit  place  to  care  for  them.  And  furthermore, 
the  county  probably  will  not  have  a  fit  place  with  any  amount  of 
money  we  can  spend.  The  new  jail  will  come  nearer  being  a  fit 
place  than  we  could  make  a  hospital  on  the  county  farm.' 

"The  county  officials  give  as  one  of  the  reasons  for  their  change 
of  plan,  with  regard  to  the  hospital  at  the  county  farm  that  if  they 
established  the  hospital  the  officials  of  the  State  Insane  Asylum 
would  be  more  inclined  to  let  patients  from  other  counties  into  the 
asylums  sooner  than  they  would  Dallas  county  patients,  because 
they  would  feel  that  the  county  was  caring  for  them  without  State 
aid.  That  would  mean  a  great  increase  of  expense  for  the  county, 
it  is  declared." 

The  News,  commenting  on  the  discussion  raised  by  the  above 
inquiry,  writes  as  follows: 

"Mr.  L.  C.  Denton  of  Sterrett,  writing  in  approval  of  something 
we  had  to  say  on  the  treatment  of  the  insane,  expresses  the  hope 
that  we  shall  'keep  agitating  the  subject  until  we  can  get  a  Gov- 
ernor who  will  carry  out  his  campaign  promises  in  regard  to 
making  adequate  appropriations  for  our  insane  asylums.'  The 
actual  task  is,  it  seems  to  us,  to  make  the  people  of  the  State  as 
sensible  as  Mr.  Denton  evidently  is  of  the  enormity  of  confining 
lunatics  in  jail.  Governors  would  not  have  been  recreant  in  this 
matter  if  they  had  not  been  encouraged  to  default  by  the  lethargy 
of  the  people.  The  people  of  Texas  can  get  pretty  much  what 
they  want  in  a  political  way,  even  when  the  thing  wanted  is  not 
altogether  good  for  them;  and  when  they  make  up  their  minds 
that  they  no  longer  want  lunatics  kept  in  jails,  that  barbarous 
practice  will  be  discontinued  with  promptitude.  The  only  reason 
why  the  people  have  not  already  given  a  peremptory  order  for  the 
abandonment  of  this  practice  is  that  they  themselves  do  not  under- 
stand the  full  consequences  of  it.     They  imagine  that  about  the 


118  Bulletin  of  the  University  of  Texas 

only  consequence  of  keeping  a  lunatic  in  a  jail  for  six  or  eight 
months  is  to  deprive  him  of  comforts  which  he  would  get  at  an 
asylum,  and  they  argue  that  since  a  lunatic  is  little  susceptible  to 
comfort  or  discomfort,  the  evil  is  not  very  great. 

"If  that  were  the  only  consequence  the  matter  would  hardly  be 
worth  a  tenth  the  bother  it  has  occasioned.  We  doubt  if.  it  makes 
any  difference  in  the  feelings  of  a  lunatic  ordinarily  whether  he 
is  in  a  jail  or  an  asylum,  although  it  sometimes  happens  that  a 
demented  person  has  lucid  intervals,  and  then  one  can  readily 
imagine  the  horror  of  finding  himself  locked  in  with  criminals 
must  be  frightful.*  The  shock  and  suffering,  we  should  think, 
must  aggravate  and  confirm  his  mental  malady  as  well  as  impair 
his  physical  health.  The  crime  we  commit  by  this  practice  is  in 
lessening  and  often  destroying  a  lunatic's  chance  of  recovery.  In 
their  incipiency  at  least  a  good  many  cases  of  lunacy  are  merely 
functional  disorders,  which  can  be  made  to  respond  to  treatment 
if  treatment  of  the  right  kind  is  given  promptly.  It  is  by  making 
prompt  treatment  difficult  and  even  impossible,  in  many  instances, 
that  we  are  guilty  of  a  crime  which  should  shame  every  citizen  of 
Texas.  We  venture  to  say  there  are  several  hundred  lunatics  in 
the  asylums  now  who  would  not  be  there  if  they  had  not  been 
denied  early  treatment.  The  State  has,  in  reality,  by  its  neglect, 
made  their  malady  permanent.  The  State  would  hardly  offend 
worse  by  killing  them  than  it  does  by  robbing  them  of  their  oppor- 
tunity to  recover  their  sanity.  The  people  of  Texas  will  order  an 
abandonment  of  this  practice  when  they  come  to  appreciate  its 
consequences,  and  when  they  give  the  order  it  will  be  obeyed." 

Ellis  County. — No  insane  in  jail.  A  few  feeble-minded  at  the 
poor  farm.  At  the  time  of  writing  there  were  a  number  of  known 
cases  of  insanity  in  the  county  awaiting  trial  or  cared  for  at  home. 
One  case  of  a  woman  about  forty-eight  years  of  age  was  investi- 
gated. The  woman  had  been  in  a  sanitarium  for  some  time  and 
after  getting  no  results  unavailing  attempts  had  been  made  to  get 
her  admitted  to  the  asylum  at  Terrell.     Her  relatives  felt  that  she 

*It  not  only  happens  but  is  true  in  the  majority  of  cases  that  are  to 
be  found  in  county  jails.  Their  lucid  intervals  are  often  much  longer 
than  the  periods  of  unconsciousness  and  indifference  to  their  surround- 
ings and  the  horror  and  fright  and  uncertainty  of  their  condition  is  pain- 
ful  in   the  extreme. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  119 

could  be  better  cared  for  there  as  the  home  physicians  admitted 
they  did  not  have  the  knowledge  and  facilities  to  treat  her.  It  is 
necessary  to  watch  her  continually  and  the  patient  thus  becomes  a 
constant  source  of  danger  to  the  immediate  family  and  the  neigh- 
borhood through  no  fault  of  tbe  home  and  in  spite  of  their  best 
efforts  to  place  her  under  proper  care.* 

Grayson  County. — One  insane  in  jail  at  tin's  time,  about  ten 
on  the  county  farm  and  twelve  idiots.  The  idiots  crawled  about 
over  the  floors  or  sat  in  their  rooms  with  only  the  care  that  one 
person  could  give  for  a  short  time  each  day.  Several  were  con- 
fined in  yards  outside  in  the  daytime  so  they  could  not  run  away. 
One  boy,  about  seventeen,  because  he  tore  his  clothes,  etc.,  was 
kept  during  the  day  with  his  hands  strapped  behind  his  back.t 
He  has  been  at  the  farm  in  this  condition  for  a  long  time.  Another 
who  knew  his  name  but  could  only  crawl  about  over  the  floor  had 
been  at  the  farm  for  six  years. X 

Conditions  both  at  the  jail  and  farm  are  very  bad.  An  ejDileptic 
boy  who  told  me  he  had  had  a  bad  seizure  that  morning  was  con- 
fined continually  in  a  barred  and  cement-floored  cell.  He  man- 
aged, he  said,  to  keep  from  hurting  himself  very  much  most  of 
the  time  by  holding  the  bars  when  he  could.  The  cells,  for  a 
number  of  these  poor  farms  have  miniature  jails,  were  decidedly 
uncleanly  and  untidy.  The  rooms  for  the  paupers  and  imbeciles 
in  the  main  building  were  clean  and  pleasant. 

Harris  County. — May  12,  1914,  there  were  thirty-three  persons 
in  the  Harris  county  jail  adjudged  insane  or  awaiting  trial  for 
insanity.  These  persons  had  been  in  jail  for  periods  ranging  from 
a  few  days  up  to  a  year  and  more.  There  seems  to  be  no  method 
by  which  a  person  once  put  in  the  jail  on  the  charge  of  insanity 
can  get  his  trial  or  can  be  removed  to  an  asylum  or  hospital  except 
at  the  pleasure  of  the  routine  court  procedure.  Applications  are 
sent  to  the  asylums,  to  all  three  at  once,  and  if  one  or  two  approve 
the  application  the  patient  is  sent  to  one  of  these  and  usually  no 

*The  writer  met  with  similar  conditions  in  practically  every  town 
visited.  These  conditions  exist  in  homes  where  no  care  or  watch  over 
the  mentally  diseased  person  is  possible,  as  well  as  in  those  homes  where 
the  best  medical  attention  afforded  by  the  local  physicians  is  possible.  In 
all  instances  the  situation  is  dangerous  to  the  community. 

fSee  plates   II,   III,   XII,  pp.    19,   52. 


120  Bulletin  of  the  University  of  Texas, 

information  concerning  the  disposal  of  the  patient  is  forwarded 
to  the  other  hospital  approving  the  application.  This  is  apparently 
the  usual  procedure  in  all  counties.  The  asylums  have  no  district 
boundaries  and  are  open  to  all  patients  in  the  various  counties 
of  the  State. 

The  thirty-three  patients  in  the  Harris  county  jail  were,  when 
visited,  in  various  states  of  mental  derangement  from  the  maniacal 
stage  to  plain  sanity.  One  man  who  had  been  in  a  nine  by  ten 
cell  with  four  others  for  seven  months  remarked  "If  I  don't  get 
out  soon  and  get  back  to  work  I'll  go  crazy."  In  a  second  cell 
there  were  five  men,  two  of  whom  were  plainly  idiots,  and  two 
others  were  probably  not  insane,  but  feeble-minded.  Two  women 
were  locked  in  dark  cells,  cells  that  had  no  windows  and  opened 
only  on  the  corridor.  It  was  absolutely  impossible  to  see  anyone 
in  the  cell  until  the  eyes  became  accustomed  to  the  darkness.  One 
of  these  patients  was  a  young  woman  about  twenty  years  of  age. 
She  was  a  mute,  Mrs.  L.  B.,  and  had  lived  all  her  life  in  Houston. 
Her  husband  was  also  a  mute.  He  had  divorced  her  recently  and 
married  another  mute.  The  matron  had  taken  pity  on  this  girl 
and  attempted  to  teach  her  to  talk,  and  with  even  this  cursory 
effort,  the  girl  had  learned  a  number  of  words.  She  seemed  to 
understand  all  that  was  said  to  her,  responding  volubly  in  the  sign 
language  when  spqken  to. 

The  county  is  remodeling  the  third  floor  of  the  jail  for  the  exclu- 
sive use  of  the  insane.  At  the  present  time  they  are  scattered 
throughout  the  jail,  as  in  the  other  county  jails  of  the  State.  The 
changes  will  better  the  condition  of  these  poor  people,  but  they 
will  still  be  behind  bars  and  on  the  bare  floors  of  a  jail.  There  is 
no  county  hospital  in  the  city,  although  there  are  enough  patients 
in  this  jail  alone  to  fill  an  entire  ward  in  such  a  hospital.  All  of 
these  thirty-three  belong  in  a  well-regulated  hospital ;  others  may  be 
found  in  the  county.  One  laboring  man  in  the  city  is  paying  $35 
a  month  to  a  private  sanitarium  in  the  city  to  keep  his  wife  out 
of  jail.  He  says  they  have  been  married  thirty  years  and  she 
has  been  a  good  wife  all  of  this  time  and  he  is  not  going  to  be 
parted  from  her  now  in  this  manner. 

Hays  County. — Here  the  jailer  and  his  wife  keep  a  jail  that  is 
ancient  in  dirt  and  decrepitude.    The  only  solid  thing  in  the  build- 


Care  of  the  Feeble-minded  and  Insane  in  Texas  LSI 

ing  is  the  two-storied  steel  cell  in  the  back.  Four  persons  occu- 
pied this  unsavory,  dark,  forbidding  cage  on  Juno  12.  One  was 
a  little  Mexican  boy  who  had  been  shipped  up  from  Mexico  but 
eight  days  before  with  a  large  number  of  others  to  work  in  the 
cotton  fields.     This  little  fellow  seems  to  have  become  unruly  from 


Plate  XXV. 

By  looking  closely  the  paralyzed  negro  woman  may  be  seen  lying  in 
the  door  of  this  ram-shackle  building.  Everything  inside  is  in  the  same 
wornout  and  useless  condition  as  the  chair  in  the  foreground.— Hill 
County  Poor  Farm. 

Laredo  on  because  the  railroads  had  forced  him  to  pay  his  fare 
from  this  point.  At  the  farm  (the  story  is  vague  and  contradic- 
tory) he  had  continued  his  bad  language  and  was  chased  by  the 
other  Mexicans  three  or  four  miles  through  the  country  till  finally 


122  Bulletin  of  the  University  of  Texas 

caught  by  the  sheriff.  The  county  physician  said  he  was  not  in- 
sane, only  ''mean."  His  meanness  must  have  been  awful,  for  when 
I  saw  him  this  frail  little  chap  was  behind  enormous  bars,  and  for 
further  safety,  for  two  days,  besides  being  in  jail,  he  had  been 
kept  handcuffed.  If  he  ever  gets  out  and  back  to  Mexico  he  will 
have  a  tale  to  tell  that  rivals  any  of  the  stories  that  come  from 
Mexico  in  the  recent  troubles.  If  this  paper  were  about  county 
jails  and  not  about  the  insane  and  feeble-minded,  the  jail  and 
courthouse  of  Hays  county  would  make  a  theme  of  dirt  and  squalor, 
unrivaled,  we  hope,  elsewhere. 

Hill  County. — Two  insane  in  jail  and  six  feeble-minded  at  the 
countv  farm.  There  were  also  six  known  cases  of  insanity  in  the 
county  awaiting  trial  or  cared  for  at  home.  Jail  was  in  good 
condition.  The  buildings  at  the  county  farm  have  long  since 
outlived  their  usefulness.  One  caretaker  described  them  as  "hat 
cages." 

Hunt  County.— The  Palmer  Bustler  of  March  20,  1911,  quotes 
as  f oIIoavs  : 

"THE   SHAME  OF  TEXAS. 

"The  shame  of  Texas  is  the  many  insane  stowed  away  in  the  jails 
and  on  the  county  farms.  Nearly  every  county  has  its  quota.  Hunt 
countv  has.  There  is  one  white  man  who  has  been  in  jail  for 
months  and  a  negro  woman  for  some  time.  The  woman  is  beyond 
hope  of  recovery,  but  perhaps  the  man's  malady  would  give  way 
to  treatment,  but  in  either  case  the  shame  is  on  a  State  which 
makes  not  enough  provision  to  take  care  of  these  unfortunates. 
It  is  no  discredit  to  the  local  authorities,  for  they  have  no  alter- 
native when  they  are  told  that  the  asylums  are  full.  Texas  has 
too  long  permitted  this  condition.  The  citizenship  should  feel 
disgraced  and  rest  not  until  this  foul  blot  is  removed.  It  is  an 
easy  matter  to  correct  it.  The  rich  State  can  supply  the  funds. 
That  is  what  is  needed.  A  little  money  to  build  and  equip  struc- 
tures for  their  protection  and  treatment. — Greenville  Banner" 

Johnson  County. — No  insane  confined  in  the  jail.  Nine  have 
been  sent  to  the  asylum  in  the  last  few  months — there  seems  to  be 
no  special  clue  indicating  the  county  that  will  succeed  in  getting 
all  its  insane  in  the  asylums  and  those  that  cannot  do  so.  At  the 
poor  farm  are  a  number  of  idiots  and  persons  absolutely  helpless. 


Care  of  the  Feeble -minded  and  Insane  in  Texas  123 

The  average  cost  of  these  to  the  county  according  to  the  county 
judge  is  $50  per  month.     Notwithstanding  this  heavy  expense  the 
county  cleared  over  $2000  on  its  farm  of  500  acres  last  year. 
The  Paris  Morning  Neivs  writes  as  follows : 

THE  IGNOMINY  OF  LAMAR  COUNTY. 

"With  all  her  boasted  wealth  of  soil,  her  magnificent  citizenship, 
her  pride  of  progress  and  her  marks  of  splendid  civilization,  dear 
old  Lamar  must  bear  forever  on  her  escutcheon  the  stain  of  one 
overwhelming  and  ignominious  disgrace,  towit,  the  unbelievably 
brutal  and  inhuman  treatment  of  her  prisoners. 

"With  a  spirit  austerely  impartial,  she  inflicts  upon  one  and  all 
the  same  ill-usage.  Whether  incarcerated  for  crime  or  misfortune; 
whether  old  and  tough  or  young  in  years  and  tender  in  life ;  whether 
in  prime  of  health  or  reeking  with  disease ;  whether  guilty  or  inno- 
cent, sane  or  insane — every  prisoner  in  the  hand  of  "Grand  Old 
Lamar"  is  consigned  to  a  den  of  darkness,  where  filth  and  infec- 
tion, stench  and  stigma,  hold  high  and  constant  carnival.  Only 
those  who  are  so  fortunate  as  to  make  immediate  bond  may  escape 
an  imprisonment  doubling  in  despicability  that  of  the  galley  slave 
of  ancient  Eome  and  redolent  of  Bunyan's  cell  in  Bedford  jail — 
(except  that  it  had  one  outlet  to  fresh  air,  while  Lamar  county 
cells  have  none). 

"Why  should  we  tune  Our  hearts  in  sympathy  to  weep  with  the* 
dirge  of  the  prisoner  of  Chilon;  or  lose  sleep  over  the  pitiful  plight 
of  the  mother  and  sister  of  Ben  Hur?  Why  should  we  stir  again 
the  embers  of  anger  in  memory  of  what  our  fathers  suffered  in  the 
darkness  and  chill  of  Federal  dungeons? 

"What  is  the  use  of  reviewing  the  infancy  of  ancient  nations  and 
of  reverting  to  the  dark  days  of  the  ignoble  past  in  order  to  heap 
anathemas  upon  a  system  that  has  ever  blazoned  the  thought  of 
"■'man's  inhumanity  to  man?" 

"In  our  own  midst  today,  at  the  very  heart  of  our  county's  cap- 
ital, surrounded  by  every  evidence  of  our  civilization,  we  citizens 
of  Lamar  county  are  perpetuating  an  institution,  the  conduct  and 
condition  of  which  should  have  been  a  scandal  to  earlier  centuries, 
and  which  is  today  unpardonable. 

"Let  us  study  a  moment  the  geography  of  our  jail. 


124  Bulletin  of  the  University  of  Texas 

"1.  As  to  location.  In  the  center  of  our  county  seat,  by  vote 
of  our  people,  we  have  erected  our  magnificent  granite  courthouse, 
surmounting  a  hill,  like  a  city  that  cannot  be  hid,  it  is  the  land- 
mark of  all  the  surrounding  country.  That  courthouse  is,  prop- 
erly, our  pride ;  and  as  our  eyes  fall  fondly  on  it  from  afar,  it  seems 
the  concrete  embodiment  of  equity,  justice  and  right.  And  yet, 
right  beneath  it,  and  to  the  north  of  it,  where  the  shadow  of  the 
courthouse  must  forever  cut  off  every  ray  of  sunlight  and  the 
volume  of  the  courthouse  must  forever  rob  it  of  the  sweet  south 
breeze;  there,  condemned  by  its  very  location,  cowers  the  Lamar 
county  jail. 

"2.  ISTow,  as  the  size  of  it.  Of  course  the  front  and  larger 
portion  of  it,  which  faces  Main  Street  and  which  is  used  by  the 
jailer  and  his  "family,  is  all  right.  But  the  prison  portion  of  it, 
where  we  incarcerate  our  male  prisoners,  is  all  wrong — absolutely 
all  wrong.  It  is  irretrievably,  irredeemably  wrong — and  it  could 
never  be  made  right. 

"The  men's  word  is  the  size  of  two  large  rooms,  being  about 
20x40  feet  in  dimension.  There  are  three  tiers  of  cells,  with 
their  "run-arounds"  one  above  another,  placed  well  back  toward 
the  center  of  the  ward  and  removed  from  every  window  so  that 
the  prisoners  may  never  get  a  breath  of  perfectly  fresh  air.  In 
the  winter  season  the  atmosphere  is  stifling,  and  the  odor  nau- 
seating in  the  extreme.  Into  this  restricted  space  "the  strong 
arm  of  the  law''"  thrusts,  without  ceremony,  as  many  as  a  hundred 
men  at  a  time,  as  occasion  demands,  though  generally  there  are 
not  more  than  forty  inmates;  and  some  of  these  remain  in  the  jail 
for  months,  or  even  years.  From  three  to  a  dozen  men  occupy 
each  cell  at  night.  These  cells  are  6x8  feet  and  the  "beds"  are 
swinging  canvas  bunks,  attached  to  the  gratings  at  each  end  of 
the  cells,  one  above  another,  and  two  or  three  abreast,  according 
as  the  patronage  of  the  institution  may  require,  thus  giving  less 
room  to  each  man  than  is  accorded  by  our  legend  to  the  cerements 
of  the  grave,  when  man  goes  to  his  allotted  six  foot  of  sod  and 
takes  his  chamber  in  his  narrow  home.  The  only  sort  of  bedding 
or  covering  supplied  is  the  very  cheapest  and  flimsiest  sort  of  cot- 
ton blankets. 

"There  is  not  a  chair,  a  bench  or  cushion  in  the  jail,  and  the  only 


Care  of  the  Feeble-minded  and  Insane  in  Texas  125 

place  a  prisoner  may  sit  is  upon  the  concrete  floor  or  on  the  iron 
grating  of  the  cell. 

"The  sanitary  arrangements  are  bad,  beyond  words  to  express. 
There  is,  of  course,  absolutely  no  chance  for  a  bath,  howsoever 
long  the  prisoner  remains.  All  have  access  to  a  hydrant.  An  old 
broken  commode,  with  no  seat  on  it,  is  located  out  in  the  open 
"run-around"  where,  under  the  unobstructed  gaze  of  all  his  fellow 
unfortunates,  he  is  forced  to  attend  to  the  necessities  of  nature, 
being  robbed  absolutely  of  the  inalienable  right  of  personal  privacy. 
I  affirm  that  such  extremities  do  violence  to  the  finest  instincts 
and  sentiments  of  human  nature. 

"The  county  health  officer  must  treat  all  the  sick,  even  the  un- 
mentionable cases  of  disease,  not  in  the  seclusion  of  a  physician's 
private  office,  but  publicly  before  the  face  of  all  the  prisoners. 
Privacy  is  absolutely  impossible;  as  is  also  segregation.  The  con- 
sumptive, with  the  hectic  flush  and  the  contaminating  cough,  is 
shut  up  in  these  quarters  with  those  who  later  on  will  probably 
pay  with  their  lives,  for  our  criminal  indifference  to  prison  con- 
ditions. 

"And  the  moral  conditions  are  worse  than  the  physical.  The 
prisoner  with  the  lingering  light  of  boyhood's  grace,  in  the  forced 
intimacy  of  such  environments,  suffers  the  corruption  of  the  hard- 
ened criminal  and  the  moral  leper;  and,  in  point  of  moral  outrage 
such  forced  infliction  should,  be  catalogued  with  the  "Abduction 
of  Helen"  or  "The  Eape  of  Lucrece." 

"In  conclusion,  such  conditions  are  diabolical,  and  the  knowledge 
of  their  existence  should  stir  public  sentiment  from  London  to 
Land's  End. 

"It  is  true  that  we  should  not  treat  criminals  with  the  courtesy 
of  honored  guests.  Nor  should  there  be  any  thought  of  palatial 
quarters  or  downy  beds,  "purple  and  fine  linen,"  or  sumptuous 
fare.  But,  in  the  name  of  Him  who  sends  his  rain  upon  the  just 
and  the  unjust  and  maketh  His  sun  to  rise  on  the  evil  and  on  the 
good,  in  His  name  I  do  affirm  that  every  prisoner  of  Lamar  county, 
whether  guilty  or  innocent,  is  our  ward  and  our  charge,  with  an 
inalienable  right  to  fresh  air,  sunshine,  sanitation  and  personal 
privacy. 

"And,  as  we  'leave  our  low-vaulted  past,'  turn  our  thoughts  to 


126  Bulletin  of  the  University  of  Texas 

a  more  glorious  future,  and  set  our  faces  toward  a  brighter  day, 
we  should  show  the  bold  initiative  of  the  man  who  tore  down  his 
old  barns  to  build  greater.  Our  old  jail  is  a  disgrace  to  civiliza- 
tion, a  menace  to  public  health  and  public  morals,  an  infringement 
on  sacred  personal  rights  and  a  sarcasm  on  the  name  of  equity 
and  justice. 

"Let  us  arouse  ourselves  as  citizens  of  the  best  and  most  highly 
favored  county  in  our  State;  let  us  circulate  petitions  calling  for 
an  election  on  the  issue  to  build  a  new  and  modern  jail,  as  we  did 
to  build  a  new  courthouse,  and  then  let  us  give  our  solid  vote  to 
blot  out  Lamar  county's  ignominy  forever. 

'"And  let  me  add  in  closing,  that  this  article  is  not  intended  and 
may  not  be  construed,  to  be  any  reflection  upon  any  officer  of  the 
county.     The  fault  is  with  the  construction  and  condition  of  the 
old  jail  itself  and  not  with  officers  who  must  enforce  law. 
Eespectfully  submitted, 

W.  B.  Kendall, 
President  Humane  Society. 

"We,  the  undersigned,  hereby  certify  that  we  have  read  the  fore- 
going article  by  W.  B.  Kendall  before  its  publication,  and  his  state- 
ments are  all  true  and  in  accord  with  the  facts  and  conditions. 

W.  A.  Lain, 

Sheriff. 
Rube  S.  Wells, 

County  Judge. 

T.    C.    GERON, 

County  Health  Officer. 

A.  W.  Neville, 
President  Paris  Progressive  Club. 

S.  W.  Williams, 
President  Board  of  Trade. 

C.  E.  Dicken, 
Secretary  Paris  Board  of  Trade." 

McLennan  County. — In  the  latter  part  of  May,  1914,  the  writer 
visited  the  McLennan  county  jail.  There  were  two  insane  persons 
in  the  jail  at  that  time,  and  the  stench  arising  from  their  quarters 
was   something  that   cannot  be  described.     One  of  these  was   an 


Care  of  the  Feeble-minded  and  Insane  in  Texas 


12 


insane  epileptic,  doubtless  refused  at  the  asylums  because  of  the 
epilepsy  and  at  the  Epileptic  Colony  because  of  the  insanity;  a 
situation  duplicated  by  an  inmate  of  the  San  Antonio  jail.  This 
girl  wore  a  single  piece  of  clothing  at  the  time  and  was  unusually 


Plate  XXVI. 

This  man  with  several  others  lives  in  a  poorly 
kept  cottage.  The  main  buildings  here'  were  well 
kept.     All  of  these  Avere  insane,  senile,  etc. 


dirty.  Through  the  bars  from  where  she  was  when  I  saw  her  was 
the  other  patient.  He  was  a  Mexican  and  was  completely  naked 
except   for  a   dirty  piece  of  sacking  that  served  as  a  loin  cloth. 


128  Bulletin  of  the  University  of  Texas 

*The  jailer  told  me  that  they  had  tried  to  get  rid  of  him  in  various 
ways.  He  spent  part  of  his  time  at  the  poor  farm  and  part  in  the 
"jail.  The  method  of  getting  rid  of  him  was  to  take  him  out  and 
turn  him  loose  in  the  country,  but  someone  always  gathered  him 
up  and  returned  him,  so  that  he  was  still  on  their  hands.. 

Tarrant  County. — Ten  insane  were  confined  in  the  jail  June  15. 
These  were  scattered  about  the  jail  in  the  worst  conditions  of  filth 
and  lack  of  care  imaginable.  One  man,  J.  G.,  had  just  been 
brought  in  from  the  poor  farm  because  they  could  not  keep  him 
there.  He  tore  off  his  clothing  and  ran  about  naked  unless  watched 
all  the  time.  In  the  jail  he  was  confined  in  a  single  cell  and 
allowed  to  remain  naked.  While  the  writer  talked  to  him  several 
negro  women  came  around  and  laughed  and  joked,  over  the  poor 
man's  condition.  The  time  of  confinement  in  the  jail  ranged  from 
a  few  days  to  over  a  year  for  the  ten  at  present  in  jail. 

At  the  poor  farm  were  several  insane  and  about  nine  distinctly 
imbecile  types.  These  constituted  sources'  of  continual  trouble 
under  the  conditions  existing.  All  of  them  would  be  useful  at 
some  work  or  other  after  training  on  a  farm  colony  for  feeble- 
minded.    Plates  I  and  XXVI. 

Travis  County. — Three  insane  in  jail;  one  has  been  there  over 
a  3'ear. 

We  might  go  on  writing  in  this  manner  for  pages.  The  sit- 
uation is  known  and  in  isolated  instances  the  humanity  of  some 
one  has  been  touched  by  the  frightful  conditions  in  which  these 
sick  people  are  kept  sometimes  for  years.  If  we  are  away  from 
the  actual  presence  of  the  jail  and  the  poor  farm  it  at  once  be- 
comes incredible  that  such  conditions  can  exist  in  Texas  in  the 
twentieth  century.  The  illustrations  above  are  not  selected.  They 
have  come  as  accident  permitted  us  to  visit  a  particular  locality, 
and  word  comes  to  us  from  all  over  the  State  that  we  are  dealing 
with  a  common  condition  in  Texas.  I  quote  below  a  table  giving 
the  number  of  insane  in  county  jails  and  on  the  poor  farms  of 
Texas  during  the  months  of  February,  March  and  April,  the  period 
during  which  the  statistics  were  being  reported  by  the  county- 
judges  and  sheriffs  of  the  State.  Only  four  counties  failed  to 
report. 

The  table  shows  the  number  of  insane  in  jail,  the  number  on 


Care  of  the  Feeble-minded  and  Insane  in  Tents 


129 


the  poor  farms,  the  number  out  "on  bond,"  and  the  number  of 
feeble-minded  in  jail  and  on  the  poor  farm  combined.  In  the  last 
column  is  given  the  number  of  insane  admitted  to  the  three  asy- 
lums for  the  insane  from  each  county  from  Augusl  •'!!.  L911,  to 
August  31,  1912, 


County. 

Insane 

in 
Jail. 

Insane 
on  Poor 
Farm. 

Insane 

Out  on 

Bond. 

■og 

"3  e 

C  CO 

O    Err, 

6  i 

Cd»H 

1 

2 

2 

8 

Andrews 

3 

3 

Aransas 

2 

Archer 

Armstrong 

1 

1 

4 

5 
2 

1 

Austin 

5 

2 

Bailey 

1 

Bandera 

1 

2 

2 

3 

Baylor 

1 

Bee 

1 
3 

17 

2 

3 

10 

1 

6 
8 

1 

Bell 

4 
2 

12 

55 

Blanco 

5 

Borden 

I 

2 
3 

8 

4 

6 

4 

Brazoria 

6 

1 

1 

1 

4 

1 

Briscoe 

Brooks 

8? 

7 

1 

Burnet 

6 

Caldwell : 

1 

1 

Callahan 

5 

2 

2 

1 

Carson 

2 

2 

3 

2 

4 

3 

Castro 

1 

10 

1 

Clay 

1 

1 

1 

1 

Coke 

i 

1 
2 
1 

6 

1 

10 

1 

1 

2 

1 

2 

1 

5 

1 

1 

1 

6 

Coryell , 

2 

2 

4 

Cottle 

1 

3 

Crane 

Crockett 

■Crosby , 

Culberson 

Dallam 

1 

I 


i 

- 


p 

s  - 


5 






- 
I 

46 

- 

Ztxna. 

r 

i 

- 
- 

1 

- 

- 

t 



:          '                               



: 

.- 

4 
• 

: 

to 

8 

- 



Fids 





F 

- 

1 

- 

3 

- 

5 

1 



- 

31 

- 



- 

- 

D 

i 

■    - 

. 

" 

1 

i 

- 

- 

4 

- 
4 

S 

3 

" 

: 

, 

i 

" 

2 





. 

l" 

- 
: 

IS 

10 

: 

2 




18 





• 

1 

L'.'.Z..'.Z'.'. 

2."" 

2 

7 

■   "     .     .                             ..     .. 

/ 

Care  of  tin   Feeble-minded  and  Insane  in  Texas 


131 


Insane 

on  Poor 

Farm. 


Insane 

Out  on         ~~ 
Bond.        -=  - 


<s 


4 

q 

1 

1 
1 
■1 

7 

3 

■J. 

1 

14 

Kendall.. 

1 

1 

1 

1 

3 

4 

10 

■- 

2? 

2 

3 

1 

1 

3 

1 

1 

3 

Liberty 

1 

1 

8 

2 



1 

2 

2 

3 

1 

1 
3 

5 

1 

4 

3 

2" 

31 

McMullen...  . 

2 

3 

1 

Midland 

1 

1 

4 

2 

7 

Mills 

3 

Mitchell 

4 

1 

1 

3 

1 

1 

2 

Motlev 

1 

2 

Xavarro 

1 

2 

2 

4 

1 

3 

5 

1 

Oldham 

1 

1 

Palo  Pinto. 

10 

3 

1 

5 

1 

6 

Parker 

4 

6 

Polk.  .. 

7 

Potter 

1 

1 

3 

1 

Randall 

2 

1 

1 

13? 


Bulletin  of  the  University  of  Texas 


County. 

Insane 

in 

Jail. 

Insane 
on  Poor 
Farm. 

Insane 
Out  on 
Bond. 

Feeble-minded 
in  Jail  and  Poor 
Farm. 

Insane,  Admitted 
1911-1912. 

1 

1 

2 

5 
4 
2 
1 

2 

7 

Rockwall 

4 

2 

Rusk 

6 

5 

1 
1 

1 

2 
2 

1 

San  Saba 

3 

Schleicher 

1? 

5 

Shackelford 

1 

Shelby 

1 

3 

Smith 

3 
1 

5 

2 

1 
1 

11 

2 

Starr 

Stephens 

3 

Sterling 

(1)  .... 

1 

Stonewall 

1 

1 

2 
13 

10 

4 

1 

32 

Taylor 

7 

1 

2    . 

1 

Throckmorton 

Titus 

2 

7 

Tom  Green 

8 

Travis , 

3 

2 

2 

29 

5 

Tyler 

2 

Upshur 

2 

4 

Uvalde 

4 

Val  Verde 

1 

1 

1 

Van  Zandt 

3 

5 

1 

2 

Walker 

5 

Waller 

1 

2 

1 

Ward 

1 

5 

4 

5 

Webb 

1 
1 

3 

1 

4 

Wheeler 

2? 
11 

Wichita 

3 

1 

8 

1 

1 

many 
1 

23 

Wilson 

4 

6 

Wise 

2 
1 

2 

7 

6 

Wood 

11 

1 

Total 

182 

78 

211 

206 

972 

Care  of  the  Feeble-minded  and  Insane  in  Texas  L33 


PBOPER  CARE  AND  TREATMENT  OF  THE  INSANE. 

In  Jerusalem,  in  the  fifth  century,  and  earlier  in  Greece  and 
Rome,  there  is  ''some  evidence  that  the  insane  were  treated  as 
individuals  suffering  from  disease.  .  .  .  But  these  ancient 
beneficent  teachings  were  lost  sight  of  during  succeeding  centuries. 
The  prevailing  idea  of  the  pathology  of  insanity  in  Europe  during 
the  middle  ages  was  that  of  demoniacal  possession.  .  .  .  Medieval 
therapeutics  in  insanity  adapted  itself  to  the  etiology  indicated. 
Torture  and  the  crudest  forms  of  punishment  were  employed.  The 
insane  were  regarded  with  abhorrence  and  were  frequently  cast 
into  chains  and  dungeons.  Milder  forms  of  mental  disease  were 
treated  by  other  spiritual  means — such  as  pilgrimages  to  the  shrines 
of  certain  saints,  who  were  reputed  to  have  particular  skill  and 
.success  in  the  exorcism  of  evil  spirits.  The  shrine  of  St.  Dymphna 
at  G-heel,  in  Belgium,  was  one  of  these,  and  seems  to  have  orig- 
inated in  the  seventh  century, — a  shrine  so  famed  that  lunatics 
from  all  over  Europe  were  brought  thither  for  miraculous  heal- 
ing.'** 

Throughout  the  middle  ages  the  process  of  gathering  the  milder 
forms  of  insanity  at  shrines  and  monasteries,  and  throwing  the 
dangerous  into  prisons  in  dungeons  and  chains  went  on.  "Bedlam" 
(Bethlehem  Royal  Hospital,  England)  began  their  care  of  the 
insane  as  early  as  1403.  In  the  seventh  century  the  distinction 
between  idiots  and  insane  and  criminals  had  become  fairly  clear; 
but  it  was  not  till  1792  that  Pinel  "struck  the  chains  from  the 
lunatics  huddled  in  the  Salpetriere  and  Bicetre  of  Paris  and  called 
upon  the  world  to  realize  the  horrible  injustice  done  to  this  wretched 
and  suffering  class  of  humanity.'"  In  1817,  Esquirol  "wrote  of 
the  insane  in  France  and  all  Europe:  'These  unfortunate  people 
are  treated  worse  than  criminals,  reduced  to  a  condition  worse  than 
that  of  animals.  I  have  seen  them  naked,  covered  with  rags,  and 
having  only  straw  to  protect  them  against  the  cold  moisture  and 
the  hard  stones  they  lie  upon;  deprived  of  air,  of  water  to  quench 
thirst,  and  all  the  necessaries  of  life;  given  up  to  mere  gaolers 
and  left  to  their  surveillance.     I  have  seen  them  in  their  narrow 

*Peterson,  F.,  Ency.  Brit.,   11th  ed.,  v.   14,  p.   616. 


134 


Bulletin  of  the  University  of  Texas 


and  filthy  cells,  without  light  and  air,  fastened  with  chains  in 
these  dens  in  which  one  would  not  keep  wild  beasts.  This  I  have 
seen  in  France,  and  the  insane  are  everywhere  in  Europe  treated 
in  the  same  way.' " 


Philippe  jPlrtel  .'fyv,  tfiM-,  £<zip2t-&i&-t?& 
Plate  XXXII. 

Fortunately  for  us  in  Texas  that  Esquirol  is  not  here  almost 
one  hundred  years  later  to  describe  the  way  we  treat  the  insane 
in  our  jails  and  on  our  poor  farms.  There  is  not  a  point  in  his 
description  that  I  have  not  seen  duplicated  in  the  jails  of  Texas  in 
the  year  1914.  I  have  seen  women  and  men  with  no  clothing  but  a 
suit  of  union  underwear  or  a  single  slip  of  loose  calico  or  completely 
naked  in  cells  where  the  sun  never  shines,  or  running  about  in  cor- 
ridors that  looked  through  bars  to  men  naked  but  for  a  dirty  loin 
cloth;  I  have  seen  thern  crowded  into  a  single  cell  where  they 
lived  day  in  and  day  out  in  close  communion  with  filth  and  dirty 
bedding,  or  lying  on  the  cold  stone  floors  with  no  bedding  at  all. 
I  have  seen  imbeciles  wallowing  about  together  over  the  floors  of 
jails,  drooling  and  unkempt,  dressed  in  clothing  as  ragged  as  any 
of  the  middle  ages  could  wear;  I  have  seen  the  insane  and  feeble- 

*Op.  cit.,  p.  617. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  135 

minded  shut  up  with  criminals  and  the  prey  to  all  the  sport  of 
such  idle  minds,  and  this  in  the  twentieth  century.  1  have  seen 
the  maniac  shut  up  in  the  dark  cell  and  loose  in  an  empty  room 
raving,  impotent  to  wreak  vengeance  except  by  spitting  in  your 
face,  or  biting  and  kicking.  I  have  seen  women  in  our  jails  with- 
out women  attendants,  who  have  forgotten  when  they  took  their 
last  bath.  All  this  I  have  seen  in  the  midst  of  the  fairest  cities 
of  Texas,  where  the  finest  that  the  world  affords  in  modem  civili- 
zation is  to  be  found. 

In  communities  where  the  advancing  thought  of  the  world  finds 
practical  application  all  this  is  different.  The  chains,  the  padded 
cell,  the  means  of  restraint,  such  as  tying  the  hands  and  feet,  the 
barred  windows,  the  six-foot,  brawny  attendant  have  all  passed 
away.  In  their  place  have  come  the  carpeted  rooms,  the  sun  par- 
lors, the  clean  and  neat  hospital  beds  with  trained  women  nurses 
for  both  men  and  women  patients,  the  newspapers  and  magazines 
and  latest  books  with  a  recreation  supervisor,  who  organizes  games 
and  various  amusements,  and  supplies  each  with  some  kind  of 
occupation  to  utilize  the  hours  till  they  are  well,  or  understand 
that  it  is  better  to  stay  in  the  hospital  than  to  go  home  or  out 
where  others  will  trouble  them. 

Hospital  organization  is  tending  more  or  less  clearly  toward  the 
following  division  of  labor.  Near  the  centers  of  population 
are  established  the  receiving  hospital.  Out  from  the  urban  center 
itself,  but  near  the  city,  is  placed  the  large  farm  colony  with  the 
buildings  arranged  as  in  any  small  village  around  certain  centers 
that  follow  the  modern  classification  of  mental  diseases  as  far  as 
possible.  These  permanent  colonies  are  filled  with  the  patients 
from  the  emergency  wards,  who  are  sent  there  to  be  treated  ac- 
cording to  the  best  known  and  modern  methods.*  It  seems  almost 
unnecessary  to  add  that  by  farm  colony  we  mean  the  farm  and 
industrial  occupations  that  go  with  the  village  life  and  outdoor  life 
of  the  country.  Occupations  that  can  be  carried  on  by  the  patients 
themselves.  Regular  work  and  recreation,  regular  and  wholesome 
food  and  sleep,  simple  pleasures  and  restful  activities  all  done  by 
the  patients.     Sleep,  exercise,  and  healthy  appetites  once  regained 

*Tuttle,  G.  T.,  Two  Days  at  Gheel,  12th  An.  Rep.,  State  Board  of 
Lunacy,  etc.,  Mass.,   1891. 


136  Bulletin  of  the  University  of  Texas 

are  the  harbingers  of  mental  sanity  for  many  mental  disorders. 
It  also  goes  without  saying  that  modern  hospitals  and  laboratories 
are  indispensable  parts  of  such  a  community.  The  treatment  may 
last  only  a  few  months,  or  it  may  last  for  years  and  end  only  with 
the  death  of  the  patient.  We  are  slow  to  describe  any  disease  as 
chronic  or  to  establish  the  idea  that  these  places  are  for  incurables. 
Ten  years  is  not  too  long  a  time  for  a  man  or  woman  to  spend  in 
one  of  these  retreats  and  come  forth  to  take  up  his  work  on  the 
outside  once  more.  Two  other  important  problems  are  met  by 
the  plan  of  the  modern  hospital.  The  treatment  of  the  borderline 
cases  before  they  can  in  any  way  be  termed  cases  of  insanity  and 
the  after  care  of  those  sent  out  recovered. 

The  modern  receiving  hospital  is  located,  as  we  have  said,  as 
near  as  possible  to  the  centers  of  population  when  it  performs  the 
three  functions  of  treating  borderline  cases,  of  handling  emer- 
gency cases,  and  overseeing  the  work  of  after  care  and  social  super- 
vision. This  hospital  frequently  also  properly  performs  the  larger 
function  of  studying  and  putting  under  the  various  forms  of  treat- 
ment, voluntary  cases  and  those  who  wish  to  remain  for  further 
intensive  treatment.  This  latter  function  is  also  properly  the 
work  of  all  hospitals  for  the  insane  and  should  be  carried  on  at  all 
colonies  where  the  insane  are  cared  for  by  the  State. 

The  hospital,  in  construction  and  fittings,  corresponds  in  con- 
siderable detail  to  the  latest  ideas  concerning  all  hospital  construc- 
tion. It  has  all  the  facilities  afforded  by  these  and  adds  certain 
other  features,  as  special  rooms  and  appliances  for  continuous 
baths,  rooms  for  sun  baths,  recreation  rooms,  outdoor  promenades 
with  space  for  games,  etc.  It  is  supplied  with  a  full  complement 
of  attendants,  trained  nurses,*  physicians  and  psychologists  wno 
carry  on  detailed  accurate  records  and  charts  of  the  physical  and 
mental  changes  during  this  period.  Careful  medical  treatment  and 
skillful  nursing  have  become  the  first  essentials  in  the  treatment  of 
all  mental  diseases.!  The  greatest  success  attends  such  procedure 
when  the  patient  is  placed  in  the  hospital  or  goes  of  his  own  accord 
at  the  first  symptoms  of  any  difficulty. 

*That  women  make  the  best  nurses  for  the  male  wards  is  one  of  the 
surprising  discoveries  of  recent  years.  The  trained  nurse  is,  of  course,, 
taking  the  place  of  the  untrained  attendant  in  all  hospitals  for  the  insane. 

tAnnual  Reports  of  Albany  Hospital,  Pavilion   F,   1903-1913. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  137 

Such  departments  should  be  in  connection  with  all  hospitals  for 
the  insane  whether  their  function  be  largely  custodial  or  not.  They 
include  the  well-equipped  laboratories  and  skilled  scientists  neces- 
sary to  discover  the  whole  history  of  patients,  from  the  social 
worker  in  the  field  gathering  histories  to  the  highly  trained  sur- 
geon and  skilled  pathologist  and  alienist.  Such  departments  must 
be  in  charge  of  men  who  have  long  experience  and  training  in 
their  respective  fields  to  produce  the  highest  grade  of  results. 
Every  hospital  ought  to  maintain  wards  for  the  voluntary  patients 
who  come  in  increasing  numbers  when  they  learn  that  they  can 
consult  men  who  are  sympathetic  and  versed  in  a  knowledge  of 
their  slightest  troubles  and  who  will  take  the  time  to  listen  to  their 
story* — a  problem  that  the  regular  practitioner  has  not  yet  learned 
to  meet  and  one  that  he  will  not  give  much  thought  to  so  long 
as  the  rush  for  numerous  patients  and  large  incomes  actuate  the 
majority  of  our  professional  men. 

The  out-patient  departments  of  such  hospitals  as  pavilion  F  at 
Albany,  the  Henry  Phipps  Institute  at  Baltimore,  the  Psycho- 
pathic Institute  at  Boston,  etc.,  show  increasing  calls  for  consul- 
tations and  treatment  among  those  who  are  not  ready  to  be  de- 
clared insane  or  do  not  need  the  routine  treatment  of  the  hospital 
ward.  Many  a  mental  worry  and  fear  is  met  in  such  departments 
by  clean,  wholesome  advice,  and  continued  counsel,  until  the 
troubled  business  man  or  the  worried  woman  is  once  more  able  to 
see  ilfe  as  it  ought  to  be.f  This  phase  of  the  work  is  also  con- 
cerned with  the  discharged  patient.  Hundreds  are  sent  away  from 
asylums  with  the  short  hasty  word  of  the  busy  physician  or  super- 
intendent. They  are  not  yet  well,  the  dread  of  a  recurrence  of 
the  disease  is  still  with  them ;  they  are  to  go  back  to  a  community 
that  is  fearful  or  hostile,  and  the  chances  against  a  complete  re- 
covery are  thus  multiplied.  In  a  wisely  conducted  department 
this  problem  is  met  by  the  visiting  nurse,  or  by  the  request  that 
the  patient  report  to  the  hospital  regularly,  or  by  the  social 
worker,  Avho  attempts  to  assist  the  patient  to  recover  his  place  in 
the  routine  of  life  outside  the  hospital. 

The  immediate  problem  connected  with  insanity  in  its  various 

*Mosher,  J.  M.,  The  Treatment  of  Mental  Diseases  in  the  Early  Stage, 
Sidney,   1911. 

tPackard,   F.   H.,   The    Munich    Psychiatric  Clinic,    1909. 


138  Bulletin  of  the  University  of  Texas 

forms  is  thus  a  medical  and  psychological  one.  The  larger  problem 
has  today  become  social  with  its  ramifications  to  be  found  in  every 
activity  of  our  complex  industrial  and  economic  life.*  The  health 
of  a  people  forced  to  the  highest  pitch  of  effort  in  our  industrial 
system  is  of  greatest  concern  to  those  who  are  interested  in  any 
commercial  enterprise.  Medical  inspection  in  school  and  factory 
is  becoming  the  rule  rather  than  the  exception.  The  influence  of 
conditions  of  study  and  work  upon  mental  health  are  today  recog- 
nized as  of  first  importance.  The  place  of  the  psychopathic  hos- 
pital and  its  trained  corps  of  assistants  must  become  larger,  and 
the  responsibilities  of  the  physician  and  the  social  expert  and 
efficiency  engineer  become  heavier,  as  the  complexities  of  living 
remove  us  from  primitive  conditions. 

LEGAL  ASPECTS  OF  INSANITY. 

Insanity  under  the  law  operates  first  by  excluding  responsibility 
for  crime;  second,  by  invalidating  legal  acts;  third,  by  affording 
ground  for  depriving  the  insane  person  by  a  legal  process  of  the 
control  of  his  person  and  property;  fourth,  by  affording  ground 
for  putting  him  under  restraint.  These  four  principles  constitute 
the  general  relation  that  the  insane  patient  has  borne  to  legal 
enactment  and  court  procedure.  Slowly  a  fifth  principle  is  emerg- 
ing: the  insane  are  disease  spots  in  the  community  and  must  be 
isolated. 

It  is  only  within  recent  years  that  the  spread  of  information 
concerning  the  prevention  and  causes  of  many  of  our  more  com- 
mon diseases  has  led  the  authorities  to  take  control  of  general 
health  conditions.  The  result  of  this  seems  to  be  that  wherever 
conditions  exist  that  are  in  any  way  inimical  to  the  life,  liberty, 
and  happiness  of  the  people,  the  authority  of  government  can  be 
invoked  to  stop  such  causes.  This  authority  is,  therefore,  spoken 
of  as  the  police  power  of  states  and  governments.  No  one  has 
ever  questioned  the  right  of  federal  government,  state  government, 
or  municipal  government  to  interfere  when  an  epidemic  is  raging 
or  a  contagious  disease  is  imminent.  Nor  has  the  power  of  govern- 
mental authority  been  questioned  when  any  individual  of  society 
is  definitely  known  to  be  dangerous  to  other  members  of  society. 

*  Folks,  Homer,  The  State  Hospitals  at  the  Parting  of  the  Ways,  Buf- 
falo, 1912. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  139 

A  great  difficulty  has  been  for  government  to  gain  the  power  to 
step  in  before  serious  injury  has  occurred  to  the  body  politic  or 
to  individual  members.  We  arrest  the  assassin  after  the  deed  has 
been  clone  or  attempted  ;  the  insane  man  is  locked  up  after  wife 
and  children  are  murdered  ;  the  rapist  is  hanged  after  the  deed ; 
just  as  we  quarantine  scarlet  fever,  diphtheria,  and  other  conta- 
gious diseases  when  they  are  discovered.  The  problem  of  preven- 
tion in  each  of  these  instances  means  that  we  desire  to  stop  action 
before  it  actually  occurs,  that  in  diphtheria  we  want  only  that  one 
case  to  appear.     We  want  to  prevent  others  from  being  infected. 

So  in  the  case  of  danger  from  the  criminally  insane,  we  are 
today  anxious  to  discover  the  insanity  before  murder,  arson,  and 
crimes  against  persons  have  been  committed.  This,  I  say,  is  the 
purpose  of  prevention.  We  are  all  quite  well  aware  that  officials 
are  slow  to  interfere  until  some  overt  act  has  taken  place.  The 
dangers,  therefore,  of  the  contagious  disease  and  the  homicidal 
maniac  still  remain  with  us.     Picking  up  the  morning  paper,  two 

such  instances  strike  the  eye.     " ,  aged  eighty-one,  a 

retired  millionaire  manufacturer  and  veteran  of  the  Civil  War, 
was  shot  and  killed  early  today  at  his  home  by  his  son.  In  a  cell 
in  a  Brooklyn  police  station  the  murderer  talked  incoherently  of 
the  incidents  leading  up  to  the  shooting,  and  gave  evidence  of 
being  insane.  He  said  he  shot  his  father  when  he  received  a 
spiritual  message  from  George  Washington."  The  same  paper 
heads  another  paragraph:  "Insane  man  runs  amuck:  Kills  two 
brothers  and  seriously  wounds  a  third  man."  In  the  body  of  the 
article  it  is  stated,  "For  two  years  efforts  had  been  made  to  have 
committed  to  the  State  asylum  for  the  insane." 

Historically,  the  attitude  of  society  toward  the  insane  can  be 
divided  into  three  periods,  each  period  standing  for  the  stage  of 
human  knowledge  and  progress  of  the  time  being.  "First,  the 
time  of  superstition  and  gross  ignorance,  when  the  insane  were 
worshiped  as  deities,  as  superhuman  beings;  second,  the  stage  of 
evolution,  when  the  human  mind  began  to  reason  and  to  look  for 
causes  and,  seeing  only  the  acts  of  the  insane  and  not  being  able 
to  understand  mental  processes  or  functions,  began  to  fear  the 
insane  and  in  dreading  the  actions  of  a  disordered  mind,  held  him 
responsible  for  his  acts  as  a  criminal."     There  is  a  third  stage, 


140  Bulletin  of  the  University  of  Texas 

where  we  realize  that  the  insane  person  is  neither  superhuman  nor 
criminal,  but  mentally  sick. 

Under  the  four  legal  divisions  given  above,  we  find  that  the 
most  important  as  far  as  the  insane  person  himself  is  personally 
concerned  is  where  he  comes  under  the  law  from  the  point  of  view 
of  confinement  and  restraint  of  liberty.  Legal  process  has  always 
been  very  careful  since  the  Magna  Charta,  for  no  man,  except  by 
lawful  judgment  of  his  peers,  could  be  punished  or  made  the 
recipient  of  legal  enactment.  This  phrase  has  commonly  been 
construed  as  the  right  of  trial  by  jury.  It  is  historically  true, 
however,  that  the  right  of  trial  by  jury  is  merely  a  form  of  pro- 
cedure intended  to  carry  out  the  principles  laid  down  above.  Any 
other  procedure  that  would  gain  the  same  end  is  legally  construed 
to  fulfill  the  requirements  of  personal  liberty.  We  have  mentioned 
above  that  the  State's  police  power  has  never  been  questioned. 
That  power  is  explicitly  "the  power  to  make  and  enforce  all  man- 
ner of  reasonable  laws  for  the  protection  of  the  lives,  health,  and 
property  of  the  citizens  of  the  State,  to  maintain  good  order  and 
promote  the  public  welfare."  .We  may  quote  two  decisions  with 
reference  to. the  definition  of  "due  process  of  law."  First,  "the 
due  process  of  lav/  is  not  confined  to  judicial  proceedings,  but 
extends  to  every  case  which  may  deprive  a  citizen  of  life,  liberty, 
or  property,  whether  the  proceedings  be  judicial,  administrative, 
or  executive."  Second,  "where  administrative  process  is  author- 
ized, it  is  as  much  due  process  of  law  as  any  other."  (National 
Conference  of  Charities  and  Corrections,  1910,  page  260.) 

It  will  be  impossible  to  give  in  any  comprehensive  way  the 
details  of  the  various  methods  of  commitment  that  have  arisen  in 
the  different  States.  There  are  three  general  attitudes  involved 
in  the  procedure  at  the  present  time.  The  first  is  that  of  commit- 
ment, technically  so  called,  and  involves  the  belief  that  the  person 
so  committed  is  unable  to  care  for  himself,  his  person  or  his 
property,  or  is  dangerous  to  society.  The  second  point  of 
view  considers  that  insanity  is  a  disease,  the  length  of  whose  course 
is  not  known,  and  during  its  course  it  disables  a  man  from  occupy- 
ing his  proper  place  in  society  and  puts  him  in  the  position  of 
one  who  may  be  prayed  upon  by  other  members  of  that  social  group. 
In    other    words/  it    places    him    here    for    care,  and    treatment, 


Care  of  the  Feeble-minded  and  Insane  in  Texas  141 

and  secondarily  only,  intends  to  protect  him  and  society.  The 
third  point  of  view  is  that  in  the  insane  person  we  have  an  individ- 
ual who  is  liable  to  he  dangerous  to  society,  who  is  incapable  of 
caring  for  himself,  and  who  is,  therefore,  sick  and  in  need  of 
treatment  from  diseases  that  necessitate  temporary  or  permanent 
isolation  from  the  social  group.  All  of  these  things  are  tentatively 
held  concerning  the  man  with  symptoms  of  mental  disease,  and 
this  point  of  view  considers  it  wise  for  the  health  of  the  individual 
and  society  to  place  this  man  temporarily  where  he  may  be  ob- 
served and  watched  and  treated  by  experts  in  his  disease.  In  short, 
we  are  concerned  here  largely  with  the  growth  of  knowledge  and 
information  concerning  mental  disease.  In  the  first  point  of  view 
we  see  the  attitude  toward  the  criminal  and  the  dangerous  mem- 
ber jof  society  exhibited;  in  the  second,  that  of  the  chronic  and 
incurable  disease,  where  the  patient  is  helpless  and  no  longer  a 
member  of  society,  but  needs  treatment;  and  in  the  last,  the  atti- 
tude of  the  modern  hospital  for  the  care  and  the  treatment  of 
emergency  cases. 

As  far  as  the  legal  procedure  under  these  three  heads  is  con- 
cerned, we  may  probably  divide  the  different  methods  into  six 
divisions.  First,  the  trial  by  jury,  as  in  ordinary  criminal  pro- 
cedure. This  is  exemplified  by  the  law  on  the  insane  in  Mississippi. 
(Code  of  Mississippi,  1906,  3219,  3220.)  A  modified  form  of  this 
is  found  in  the  trial  by  jury  as  in  criminal  procedure,  but  here 
the  law  demands  that  physicians  shall  be  present  and  give  testi- 
mony in  the  premises.  This  is  a  common  modification  of  the  right 
of  trial  by  jury  and  is  found  in  a  great  many  of  the  States.  A 
third  and  far  less  common  form  is  the  establishment  of  a  com- 
mission of  at  least  two  licensed  physicians,  who  make  sworn  state- 
ments, and  the  court,  county  or  probate,  certifies  to  these  state- 
ments. This  form  of  the  law  is  in  use  in  Illinois  and  Oklahoma. 
(Illinois  Revised  Statutes,  1908,  Chapter  85.)  The  fourth  method 
of  commitment  is  by  certificate  of  lunac}r,  made  out  and  signed  by 
two  reputable  physicians,  and  the  order  is  granted  by  the  court. 
In  this  case,  as  in  the  above,  the  patient  may  or  may  not  come 
before  the  judge  as  conditions  seem  to  require.  This  mode  of 
procedure  is  used  in  several  States,  notably  New  York.  The  phy- 
sicians must  be  graduates  of  an  incorporated  medical  college,  must 


142  '  Bulletin  of  the  University  of  Texas 

have  been  in  actual  practice  three  years,  and  must  have  a  copy  of 
the  certificate  showing  such  qualifications  filed  with  the  lunacy 
commission.  A  fifth  procedure  is  known  as  voluntary  com- 
mitment. In  this  case  the  patient  himself  may  apply  to  an  insti- 
tution and  be  admitted  for  treatment.  He  must  make  written 
application  and  accompany  this  by  certificate  showing  the  county 
in  which  he  resides.  He  may  leave  the  hospital  at  any  time  on 
three  days'  notice  given  to  the  superintendent.  (Eevised  Statutes 
of  Illinois,  1908,  Chapter  85.)  This  mode  of  commitment  is  per- 
mitted in  a  large  number  of  the  States.  It  is  interesting  to  note 
that  more  and  more  persons  are  taking  advantage  of  these  privi- 
leges. We  are,  of  course,  aware  that  this  mode  of  entrance  to  hos- 
pitals for  treatment  has  been  used  by  friends,  relatives,  and  patients 
themselves  for  many  years,  but  largely  only  in  the  cases  of  nervous 
diseases,  insomnia,  and  the  simpler  and  less  extreme  types  of  men- 
tal disorder.  The  sixth  type  of  commitment  is  in  use  in  two 
States  only  with  any  degree  of  completeness  and  under  legal  pro- 
cedure— Massachusetts  and  New  York.  In  this  case  the  super- 
intendent of  any  hospital  for  the  insane  may  "without  an  order 
of  the  judge,  receive  and  detain  for  not  more  than  five  days  any 
person  whose  case  is  certified  to  be  one  of  violent  or  dangerous 
insanity  or  other  emergency  by  two  physicians  as  qualified  by  law." 
(Laws  of  1911,  Chapter  273,  12.)  The  New  York  law  reads: 
"If  an  insane  person  needs  immediate  care  or  treatment,  or  is 
dangerously  insane,  he  must  at  once  be  received  by  State  or  licensed 
institution  authorized  by  law  to  care  for  the  insane,  or  a  certificate 
of  lunacy  executed  by  two  medical  examiners  in  lunacy  after  exami- 
nation upon  the  presentation  of  a  proper  petition,  but  may  not  be 
retained  for  a  period  exceeding  ten  da}^s."  (Hospital  Commission 
Insanity  Law,  82.) 

In  conveying  patients  to  the  hospital  and  in  their  transfer  from 
one  institution  to  another,  the  work  has  usually  been  left  to  the 
sheriff  or  the  male  attendants.  All  recent  law  is  mandatory  that 
all  female  patients  shall  be  accompanied  by  a  person  of  their  own 
:  sex  or  at  least  by  a  close  relative.  The  conveyance  should  be  made 
in  as  unostentatious  and  careful  manner  as  possible.  We  are  not 
dealing  with  criminals  but  with  sick  people.  This  idea  cannot 
be  said  too  often  or  impressed  too  frequently  on  those  who  must 


Care  of  the  Feeble-mvnded  and  Insane  in  Texas  143 

deal  with  the  insane  and  yet  are  not  fully  informed  concerning 
the  nature  of  mental  troubles.  In  parole  and  discharge,  two 
points  are  worthy  of  notice.  Careful  preparation  of  the  patient 
about  the  dangers  of  the  life  that  he  must  enter  once  more  is 
essential.  Modern  legal  enactment  is  also  dealing  more  directly 
with  the  problem  of  the  increase  of  insanity  through  the  passage 
of  sterilization  laws.  The  prime  purpose  of  sterilization  laws  is 
eugenical ;  the  stoppage  of  degenerative  strains  under  strict  legal 
procedure  and  after  expert  investigation  is  consonant  with  best 
modern  social  theory.  All  members  of  the  various  institutions- 
discussed  under  the  title  of  this  paper  should  be  subjected  to  com- 
plete examination  before  release.  The  details  of  such  a  policy 
cannot  be  discussed  here.*  Defective  strains  are  of  no  value;  they 
cost  every  man,  woman,  and  child  on  an  average  of  $3.00  per  year 
in  direct  State  taxes  and  indirectly  sums  that  are  and  always  will 
be  un  known,  f 

XEEDS  OF  TEXAS. 

Little  further  consideration  is  needed  to  see  that  Texas  is  not 
in  the  forefront  of  modern  civilization  in  matters  pertaining  to 
the  treatment  and  regulation  of  its  defective  classes.  We  are  pro- 
gressing along  the  lines  that  all  people  do  who  do  not  think  till 
they  are  compelled  to  by  calamity.  We  are  not  even  thoroughly 
conversant  with  the  real  outcome  of  the  progress  that  we  are  mak- 
ing. It  is  not  wholly  toward  better  things.  Our  taxes  mount  up 
and  we  call  upon  Governors  and  politicians  to  reduce  them;  our 
jails  fill  and  we  build  new  and  costlier  ones,  and  our  existing 
institutions  call  continually  for  more  money  and  more  space;  we 
grudgingly  heed  their  cry,  never  once  asking  why  they  are  forced 
to  make  this  continual  appeal.  By  our  heedless  methods  we  create 
more  disease  and  larger  numbers  of  degenerates,  then  still  care- 
less, throw  them  into  jails  and  prisons  and  asylums  to  make  room 
in  our  cities  and  homes  for  the  numbers  that  are  coming.     If  the 

*Judge  McPherson  of  the  U.  S.  District  Court,  sitting  in  Iowa,  in 
June,  1914,  handed  down  a  decision  on  the  Iowa  sterilization  law,  stating 
that  it  constituted  cruel  and  unusual  punishment,  and  became  a  "bill  of 
attainder." 

fFor  a  detailed  and  comprehensive  discussion  of  the  program  ol 
eugenics,  see  Eugenics  Record  Office  Bulletins  Nos.   10A  and  10B. 


144  Bulletin  of  the  University  of  Texas 

State  were  run  on  the  policy  of  a  wisely  established  business  it 
could  clean  its  streets  and  by-ways  of  the  more  serious  defective 
strains  in  half  a  century,  and  the  actual  cost  measured  over  the 
same  period  of  time  would  be  billions  of  dollars  less  than  our 
present  lack  of  plan,  will  finally  cost. 

The  first  organized  and  wise  attempt  to  develop  a  plan  will  be 
made  in  the  establishment  of  a  State  Board  of  Charities  for  the 
study  and  supervision  of  existing  conditions  and  institutions  of 
the  eleemosynary  character.  Such  a  board  needs  no  power  of  con- 
trol nor  any  power  of  administration.  The  writer  is  convinced 
that  the  people  are  interested  enough  in  their  own  welfare  and 
in  that  of  others  to  act  when  they,  know  what  conditions  are  and 
what  to  do  to  better  those  conditions. 

But  argument  is  apart  from  the  purpose  of  this  summary.  We 
have  attempted  to  collect  the  main  evidence  showing  the  nature  of 
the  problems  that  Texas  must  meet  if  she  avoid  the  mistakes  of 
older  States  and  countries;  and  even  a  cursory  glance  at  the  actual 
situation  now  existing  has  given  us  'abundant  proof  that  these 
dangers  are  already  upon  us.  All  this  paper  can  do  further  is  to 
restate  the  needs  of  Texas  as  shown  by  the  means  and  methods 
now  in  use  in  countries  that  have  been  forced  to  act  and  to  solve 
just  such  problems  as  we  have  confronting  us  now.  They  cannot 
in  any  sense  be  viewed  as  the  final  solution  or  as  even  sufficient 
unto  the  present  evils  arising.  But  those  who  see  us  doing  these 
things  will  know  that  we  have  a  plan  and  that  our  work  is  not  as 
the  blind  leading  the  blind. 

1.  Texas  needs  a  board  of  study  and  supervision  with  full 
power  to  collect  data,  to  publish  it,  and  to  recommend  comprehen- 
sive legislation. 

2.  Texas  needs  better  psychopathic  hospital  facilities  with  mod- 
ern laboratories  in  charge  of  specialists,  primarily  as  an  important 
new  educational  force  within  her  borders. 

3.  Texas  needs  to  prepare  herself  to  care  for  all  her  feeble- 
minded in  a  modern  institutional  colony.  She  needs  to  face  the 
problem  honestly  and  seriously,  realizing  that  at  the  present  time 
the  problem  is  being  aggravated  by  the  multiplication  of  these 
defective  strains. 

4.  Texas  needs  a  complete  revision  of  her  laws  and  methods 


Care  of  the  Feeble-minded  and  Insane  in  Texas  145 

of  handling  both  the  feeble-minded  and  the  insane.  ISTo  one  of 
either  of  these  classes  should  ever  he  free  to  wander  in  our  streets 
or  left  to  the  filth  and  neglect  of  out  jails  and  poor  farms. 

5.  Texas  needs  to  conserve  her  resources  of  human  life  and 
wisely  to  prepare  for  her  future  millions.  She  has  time,  if  prop- 
erly used,  to  avoid  the  costly  errors  of  older  States. 


146  Bulletin  of  the  University  of  Texas 


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•Indiana  Village  for  Epileptics,  New  Castle,  Indiana.     Nos.  3,  4, 

5,  6,  7  for  1908,  1909,  1910,  1911.     Indianapolis. 
•Iowa  Institutions  for  F.   M.     G-lenwood,  Iowa.     Nineteenth  re- 
port, June,  1912. 
Annual    Eeport   of  the   Board  of  Trustees  of  the   Massachusetts 

General  Hospital.     From  the  year  1843  to  date  (with  a  few 

omissions) . 
McLean  Hospital,  Waverly,  Mass.     Descriptive  pamphlet. 
•Michigan  Home  for  F.  M.  and  Epileptic,  Lapeer,  Mich.     Ninth 

biennial  report.     1912.     Lansing,  Mich. 
•Minnesota   School  for  Feeble-minded  and  Colony  for  Epileptics, 

Minneapolis,  Minn.,  1910,  1912. 
•New  Jersey  State  Village,  Skillman.     Sixteenth  report,  1913. 
•New  York.     Syracuse  Institution.     1913.     Sixty-third  report. 
•Sixty-second  Annual   Report   of   the   Managers   of  the   Syracuse 

State    Institution   for    Feeble-minded    Children,   year   ending 

September  30,  1912.     Part  I. 
•Report  of  the  Commission  to  Select  a  Site  for  the  Eastern  New 

York  State  Custodial  Asylum,  1908. 
*New  York,  Rome  State  Custodial  Asylum,  1911,  1912,  seventeenth 

and  eighteenth  reports. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  151 

*Tenth  Annual  Report  of  the  Managers  and  Officers  of  the  Craig 
Colony  for  Epileptics.  Sonyea,  Livingston  county,  New 
York,  1903. 

*Fourth  Annual  Report  of  the  Board  of  Managers  of  Letchworth 
Village,  Albany,  January,  1913. 

*Report  of  the  Commission  on  the  Segregation,  (are  and  Treat- 
ment  of  Feeble-minded  and  Epileptic  Persons  in  the  Com- 
monwealth of  Pennsylvania.     Printed  1913.     Copy  of  law. 

'"Fiftieth  Annual  Eeport  Pennsylvania  Training  School  for  Feeble- 
minded Children.     1902.      Elwyn,  Delaware  county.  Pa. 

*  Pennsylvania  Training  School,  Elwyn,  Pa.,  1911-1912. 
'■"Pennsylvania  State  Institution  for  F.  M.  of  Western  Pennsylvania, 

Polk,  Venango  Co.,  Oil  City,  Pa.,  1912. 

^Pennsylvania,  Eeport  of  Board  of  Commissioners  of  Public  Char- 
ities, Harrisburg,  1914.  Forty-third  annual  report  for  year 
of  1912. 

*Texas.  Fifty-first  Annual  Eeport  of  the  Superintendent  of  the 
State  Lunatic  Asylum,  Austin,  Texas,  1912. 

*Twenty-eighth  Annual  Eeport  of  the  Board  of  Managers  and 
Superintendent  of  the  North  Texas  Hospital  for  the  Insane, 
Terrell,  Texas,  1912. 

*  Twenty-first  Annual  Eeport  of  the  Board  of  Managers  and  Super- 

intendent of  the  Southwestern  Insane  Asylum,  San  Antonio, 
Texas,  1912, 

*Ninth  Annual  Eeport  of  the  Superintendent  and  Board  of  Man- 
agers of  the  State  Epileptic  Colony,  Abilene,  Texas,  1912. 

*Bill.  H.  B.  No.  90.  An  Act  to  provide  for  the  purchase  of  a 
site  for  and  the  establishment,  location  aD'l  construction  of  a 
branch  asylum  in  Northwest  Texas  for  care  and  treatment  of 
the  insane,  and  to  make  appropriation  therefor,  and  declaring 
an  emergency. 

*Bill.  II.  B.  No.  165.  An  Act  relating  to  the  admission  of  pa- 
tients into  the  insane  asylums  of  Texas.     Cf.  S.  B.  No.  157. 

*Bill.  S.  B.  No.  187.  An  Act  to  provide  for  the  establishment 
and  maintenance  of  a  State  Training  School  and  Home  for 
the  Feeble-minded  of  Texas.     Cf.  H.  B.  No.  376. 

*Bill.  S.  B.  No.  188.  An  Act  to  authorize  the  sterilization  of  a 
certain  class  of  criminals,  lunatics  and  epileptics  and  syphi- 


152  Bulletin  of  the  University  of  Texas 

Jitics  and  persons  with  axi  hereditary  tendency  to  congenital 
diseases  of  mind  or  body  ...  in  any  eleemosynary  or 
penal  institution  of  the  State  of  Texas. 
*Home  for  Feeble-minded.  Biennial  report,  Madison,  Wis.,  1898, 
1900,  1906,  1908,  1910.  First  report,  1898,  p.  320;  second, 
1900  (four  boys  and  one  gardener  on  sixteen  acres  raised  $2000 
worth  of  vegetables).  Superintendent  Wilmarth  give?  excel- 
lent summaries  in  these  reports. 

MAGAZINE   ARTICLES. 

Abbot,  E.  S. — Immunity  and  Cure.  Boston  Medical  and  Surgical 
Journal,  December  19,  1895. 

Abbot,  E.  S. — The  Criteria  of  Insanity  and  the  Problems  of  Psy- 
chiatry. Proceedings  of  the  Medico-Psychological  Association, 
Quebec,  1902. 

Abbot,  E.  S. — A  Few  Remarks  About  Observation  Wards  and  Hos- 
pitals.    Amer.  J.  of  Insanity,  LXI,  No.  2,  1901. 

Abbot,  E.  S. — Forms  of  Insanity  in  five  years  admissions  to,  and 
discharges  from  the  hospitals  for  the  insane  in  Massachusetts. 
Proceedings  of  the  Amer.  Medico-Psychological  Ass'n,  sixty- 
fifth  annual  meeting,  N.  J.,  1909. 

-Abbot,  E.  S. — -Psychology  and  the  Medical  School.  Amer.  J.  of 
Insanity,  Vol.  LXX,  No.  2,  October,  1913. 

Baldwin,  B.  T. — The  Psychology  of  Mental  Deficiency.  Popular 
Science  Monthly,  July,  1911. 

Barker,  L.  F. — -Some  Phases  of  the  Mental  Hygiene  Movement  and 
the  Scope  of  the  Work  of  the  National  Committee  for  Mental 
Hygiene.     National  Com.  for  Mental  Hygiene,  No.  1,  1912. 

Barker,  L.  F. — Principles  of  Mental  Hygiene  Applied  to  the  Man- 
agement of  Children  Predisposed  to  Nervousness.  National 
Com.  for  Mental  Hygiene,  No.  2,  1911. 

Barker,  L.  F. — The  Psychic  Side  of  Medicine.  Univ.  Eecord, 
Chicago,  Vol.  XII,  No.  1,  July,  1907. 

Breckenridge,  S.  P.,  and  Abbott,  E. — The  Delinquent  Child  and 
the  Home.     New  York,  1912. 

Clark,  L.  P, — Idiocy  and  Laboratory  Research.  Survey,  Vol.  27, 
October,  March,  1911-1912,  p.  1857. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  153 

*Colliver,  J.  A. — The  Physical  Basis  for  Irritability  in  Boys — the 
Beginning  of  Juvenile  Delinquency.  Bep.  and  Manual  of 
Juvenile  Court  of  Los  Angeles  County,  1912. 

Cowles,  E. — The  Traiuing  Schools  of  the  Future.  Seventeenth  an- 
nual report  of  the  National  Conference  of  Charities  and  Cor- 
rections, 1890. 

Cowles,  E. — Neurasthenia  and  Its  Mental  Symptoms.  The  Shat- 
tuck  Lecture.    Boston,  1891. 

Cowles,  E. — The  Belation  of  Mental  Diseases  to  General  Mediciue. 
Boston  Med.  and  Surg.  Journal,  September  16,  1897. 

Cowles,  E. — Advanced  Professional  Work  in  Hospitals  for  the  In- 
sane.    Amer.  J.  of  Insanity,  LV,  No.  1,  July,  1898. 

Davenport,  C.  B. — The  Nams :  The  Feeble-minded  as  Country' 
Dwellers.     Survey,  Vol.  27,  1911-1912,  p.  1844. 

Davis,  K.  B. — Feeble-minded  Women  in  Keformatory  Institutions. 
Survey,  Vol.  27,  1911-1912,  p.  1849. 

Everybody's  Magazine,  June,  1914,  pp.  798f.  "What  We  Know 
About  Bum." 

Fenning,  F.  A. — Sterilization  Laws  from  a  Legal  Standpoint.  J. 
of  Amer.  Inst,  of  Criminal  Law  and  Criminology,  Vol.  4, 
March,  1912,  p.  804. 

Fernakl,  W.  E.— The  Templeton  Farm  Colony  for  the  Feeble- 
minded.    Survey,  Vol.  27,  1911-1912,  p.  1873. 

Folks,  H. — After-care  of  the  Insane.  State  Hospital  Bulletin, 
November,  1913. 

Folks,  H.— The  State  Hospitals  at  the  Parting  of  the  Ways.  Buf- 
falo, N.  Y.,  September  6,  1912. 

Franz,  S.  I. — Studies  of  Feeble-minded.  J.  of  Philosophy,  Psy- 
chology and  Scientific  Methods,  Vol.  II,  No.  11,  May  25,  1905. 

Goddard,  H.  H. — Heredity  of  Feeble-mincledness.  Eugenics  Bec- 
ord  Office  Bulletin  No.  1.  Beprinted  from  American  Breed- 
ers' Magazine,  I,  No.  3,  165-178. 

Goddard,  H.  H. — Two  Thousand  Normal  Children  Measured  by 
the  Binet  Measuring  Scale.     Ped.  Sem.,  June,  1911. 

Goddard,  H.  H. — A  Bevision  of  the  Binet  Scale.  The  Training 
School,  Vol.  VIII,  No.  4,  June,  1911. 

Goddard,  H.  H. — The  Basis  for  State  Policy :  Social  Investigation 
and  Prevention.     Survey,  Vol.  27,  1911-1912,  p.  1852. 


154  Bulletin  of  the  University  of  Texas 

Gocldarcl,  H.  H. — The  Height  and  Weight  of  Feeble-minded  Chil- 
dren in  American  Institutions.  J.  of  Nervous  and  Mental 
Disease,  Vol.  39,  No.  4,  April,  1912. 

Goddard.  H.  H. — Sterilization  and  Segregation.  Bull,  of  Amer. 
Acad,  of  Medicine,  XIII,  No.  4,  August,  1912. 

*  Goddard,  H.  H. — The  Responsibility  of  Children  in  the  Juvenile 
Court.  J.  Amer.  .Inst,  of  Criminal  Law  and  Crinimonogy, 
September,  1912,  p.  3. 

Gocldarcl,  H.  H. — Feeble-mindedness :  Its  Causes  and  Consequences. 
Macmillan.     1914. 

*Graves,  M.  L.— The  Care  of  the  Insane.  Bulletin  No.  63.  Uni- 
versity of  Texas,  June,  1905. 

•*Hart,  H.  H.— Juvenile  Court  Laws  in  U.  S.     New  York,  1910. 

Hoch,  August — Kraeplin  on  Psychological  Experimentation  in  Psy- 
chiatry,    xlmer.  Journ.  Insanity,  January,  1896. 

Hoch,  August — A  Eeview  of  Psychological  and  Physiological  Ex- 
periments Done  in  Connection  with  the  Study  of  Mental  Dis- 
eases.    Psychol.  Bull.,  I,  Nos.  7-8,  1904. 

*The  Institution  Quarterly,  Vols.  3  and  4,  Nos,  1,  2,  and  3,  Spring- 
held,  111.     Excellent  articles  and  statistical  data. 

Johnstone,  E.  E. — Public  Provision  for  the  Feeble-minded.  Sur- 
vey, Vol.  27,  1911-1912,  p.  1864. 

Johnstone,  E.  R. — Public  Provision  for  the  Feeble-minded.  The 
Survey,  Vol.  27,  March,  1912,  pp.  1864f. 

Johnstone,  E.  E. — A  Plan  for  the  Care  of  the  Feeble-minded.  The 
Training  School,  Vol.  9,  p.  99. 

Johnson,  Alexander — Care  and  Training  of  the  Feeble-minded. 
The  South  Mobilizing  for  Social  Service.     1913,  pp.  246f. 

Johnson,  E.  H. — Feeble-minded  as  City  Dwellers.  Survey,  Vol. 
27,  1911-1912,  p.  1840. 

Jones,  E.  K. — Libraries  for  the  Patients  in  Hospitals  for  the  In- 
sane.   Amer.  J.  of  Insanity,  LXVII,  No.  1,  July,  1911. 

Jones,  E.  K. — State  Control  of  State  Hospital  Libraries.  Amer. 
J.  of  Insanity,  LXVIII,  No.  4,  April,  1912. 

Journal  of  Abnormal  Psychology,  Vols.  1-6  (1906-1912). 

"Jvirkbride,  F.  B.— The  Eight  to  be  Well  Born.  Survey,  Vol.  27, 
1911-1912,  p.   1838. 

Kite,  E.  S.— Two  Brothers.     Survey,  Vol.  27,  1911-1912,  p.  1861. 


Care  of  the  Feeble-minded  and  Insane  in  Texas  155 

Little,  C.  S.— Letch  worth  Village:  The  Newesl  Slate  Institution 
for  the  Feeble-minded  and  Epileptic.  Survey,  Vol.  27,  1911- 
1912,  p.  1869. 

Mosher,  J.  M.— Mental  Wards  in  General  Hospitals.  New  York 
Medical  Journal  and  Phila.  Medical  Journal,  May  27,  1905. 

Mosher,  J.  M. — Pavilion  F,  Department  for  Mental  Diseases  of 
the  Albany  Hospital.  Thirty-fourth  National  Conference  of 
Charities  and  Corrections,  Minneapolis,  Minn,  June,  1907. 

Mosher,  J.  M. — A  Consideration  of  the  Need  of  Better  Provision 
for  the  Treatment  of  Mental  Disease  in  Its  Early  Stages. 
Amer.  J.  of  Insanity,  LXV,  No.  3,  January,  1909. 

Mosher,  J.  M. — The  Problem  of  the  Acute  Mental  Case.  Albany 
Medical  Annals,  December,  1910. 

Mosher,  J.  M. — The  Training  of  Nurses  in  Mental  Affections. 
Tenth  annual  meeting  of  the  New  York  State  Nurses'  Asso- 
ciation, Albany,  N.  Y.,  October,  1911. 

Mosher,  J.  M. — The  Treatment  of  Mental  Disease  in  the  Early 
Stage.  Ninth  Session  of  the  Australasian  Medical  Congress, 
Sidney,  September,  1911. 

Norsworthy,  Naomi — The  Psychology  of  Mentally  Deficient  Chil- 
dren. Archives  of  Psychology,  No.  1,  November,  1906.  Co- 
lumbia Univ.  Contributions  to  Philosophy  and  Psychology, 
ATol.  XV,  No.  2. 

Packard,  F.  H. — The  Munich  Psychiatric  Clinic.  Eeport  of  the 
State  Board  of  Insanity,  1909.     . 

Payne,  C.  E. — The  Paranoia  Problem.  Psychoanalytic  Beview, 
A^ol.  I,  No.  1,  November,  1913,  pp.  76-93. 

*Potts,  C.  S. — General  Supervision  and  Control  of  Charitable  and 
Correctional  Institutions.  The  South  Mobilizing  for  Social 
Service.     1913,  p.  306f. 

Prince,  Morton — The  New  Psychology  and  Therapeutics.    1911. 

Psychological  Clinic,  Vols.  1-6  (1907-1913).    Philadelphia. 

Schlapp,  M.  G. — The  Courts  as  Sifters:  Feeble-minded  Boys  and 
Crime.     Survey,  Vol.  27,  1911-1912,  p.  1816. 

*Spaulding,  E.  E.,  and  Healy,  W. — Inheritance  as  a  Factor  in 
Criminology.  J.  of  Amer.  Inst,  of  Criminal  Law  and  Crim- 
inology, Vol.  IV,  March,  1914,  p.  837. 


156  Bulletin  of  the  University  of  Texas 

S3'mposium.  Franz,  Meyer,  Southard,  Watson,  Prince.  The  Ee- 
lations  of  Psychology  and  Medical  Education.  J.  of  Amer: 
Med.  Ass'n,  March  30,  1912,  Vol.  LVIII,  909-921. 

The  Training  School,  Vols.  8-9   (1911-1913).     New  Jersey. 

Travis,  T. — The  Young  Malefactor:  A  Study  in  Juvenile  Delin- 
quency— Its  Causes  and  Treatment.     New  York,  1908. 

Tuttle,  G.  T.— Two  Days  at  Gheel.  Twelfth  Annual  Eeport  of  the 
State  Board  of  Lunacy  and  Charity  of  Massachusetts,  Jan- 
uary, 1891. 

Tuttle,  G.  T.— The  Male  Nurse.  Amer.  J.  of  Insanity,  LXIII, 
No.  2,  October,  1906. 

Tuttle,  G.  T. — Hydrotherapeutics.  Amer.  J.  of  Insanity,  LXI, 
No.  2,  1901. 

Weeks,  D.  F. — The  Inheritance  of  Epilepsy.  New  Jersey  State 
Village,  Skillman,  N.  J. 

Weeks,  D.  F.— What  New  Jersey  is  Doing  for  the  Epileptic,  Skill- 
man,  N.  J.    Arch,  of  Peek,  Vol.  29,  April,  1912. 

Wells,  F.  L. — The  Advancement  of  Psychological  Medicine,  Pop- 
ular Science  Monthly,  January,  1913. 

Wilmarth,  A.  W. — Eesults  of  Heredity  and  Their  Bearing  on  Pov- 
erty, Crime  and  Disease.    Wis.  Med.,  Vol.  9,  1910. 


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